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[Long-term course of anorexia nervosa]
Schweizerische Medizinische Wochenschrift
|October 23, 1976
Summary
Long-term follow-up of anorexia nervosa patients shows a poor prognosis remains, but not as hopeless as presumed. Many patients experience lasting eating issues, though marriage and children are possible, with some relapsing during major life transitions.
Area of Science:
- Psychiatry
- Psychotherapy
- Clinical Psychology
Context:
- Anorexia nervosa (AN) is a severe eating disorder with historically poor prognosis.
- Long-term outcomes of stationary psychotherapeutic treatment for severe AN are not fully understood.
- This study revisits 20 female patients treated 8-16 years prior.
Purpose:
- To assess the long-term prognosis and outcomes of severe anorexia nervosa after stationary psychotherapeutic treatment.
- To identify factors correlating with positive and negative prognoses in AN patients.
- To investigate the impact of AN on adult life, including marriage, fertility, and mental health.
Summary:
- A 20-patient follow-up revealed a persistent poor prognosis for anorexia nervosa, with 5 chronic cases and 2 transitioning to psychosis.
- One patient died from AN. Outcomes align with the 1/3 unimproved, 1/3 improved, 1/3 cured model.
- Despite illness freedom, many patients retain anorectic traits, low weight, and eating difficulties.
Impact:
- Positive prognosis linked to early onset (<18), no laxative abuse, and marriage.
- Negative factors include premature treatment interruption and return to the parental home.
- Marriage and childbirth occurred in most patients, but 4 relapsed during engagement/pregnancy, highlighting role transition challenges.
- Long-term amenorrhea did not impede fertility in married patients desiring children.