OUTCOME OF ANOREXIA-NERVOSA - A CASE-CONTROL STUDY

Objective: Although there have been many studies of the outcome of ano rexia nervosa, methodological weaknesses limit their interpretation. T he authors used a case-control design to try to improve knowledge abou t the outcome of anorexia nervosa. Method: All new female patients ref erred to an eating disorders service between Jan. 1, 1981, and Dec. 31 , 1984, who had probable or definite anorexia nervosa were eligible fo r inclusion. Of these women, 86.4% (N=70) were located and agreed to p articipate, The comparison group (N=98) was a random community sample. All subjects were interviewed with a structured diagnostic instrument . Results: A minority of the patients (10%) continued to meet the crit eria for anorexia nervosa a mean of 12 years after initial referral. E ven among those who no longer met these criteria, relatively low body weight and cognitive features characteristic of anorexia nervosa (perf ectionism and cognitive restraint) persisted. The rates of lifetime co morbid major depression, alcohol dependence, and a number of anxiety d isorders were very high. Conclusions In the managed care/brief treatme nt era, therapeutic approaches with an excessive focus on weight gain that neglect the detection and treatment of associated psychological f eatures and comorbidity may be inappropriate. Anorexia nervosa is a se rious psychiatric disorder with substantial morbidity.