Personality disorders and psychiatric morbidity over the course of juvenile anorexia nervosa: Results of a prospective 10-year catamnesis

The aim of the current study was to examine at regular intervals the course of the eating disorder symptoms and the psychiatric (co-) morbidity includ ing personality disorders among juvenile patients who fulfilled the DSM-III -R criteria for anorexia nervosa. Ten years after release from hospital all 39 patients (100%), as well as a control group parallelized for age, gende r and occupational status were personally followed-up. Symptoms of eating d isorders were documented by means of the Standardized Interview for Anorexi a and Bulimia nervosa (SIAB, Fichter et al., 1991), the Composite Internati onal Diagnostic Interview (WHO, 1990) was applied to diagnose psychiatric ( co-) morbidity, and the Structures Clinical Interview (SKID-II, Spitzer et al.. 1993) to assess personality disorders. Compared to the control group, at the tome of follow-up a significantly greater number of patients were su ffering from a psychiatric disorder, primarily an anxiety disorder, an affe ctive disorder or from drug, respectively alcohol abuse. Personality disord ers, chiefly anxious-avoidant types on the DSM-III-R were diagnosed among a lmost one-fourth of the patients. Our findings indicate that anorexia nervo sa is not a developmental disorder limited to puberty but a disorder associ ated both cross-sectionally as well as longitudinally with psychiatric diso rders.