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Adolescent-onset anorexia nervosa: 18-year outcome
Elisabet Wentz1, I Carina Gillberg, Henrik Anckarsäter
1Institute of Neuroscience and Physiology, Child and Adolescent Psychiatry, Göteborg University, Otterhällegatan 12 B, SE-411 18 Göteborg, Sweden. elisabet.wentz@vgregion.se
The British Journal of Psychiatry : the Journal of Mental Science
|February 3, 2009
Summary
The long-term prognosis for teenage-onset anorexia nervosa is favorable regarding mortality and persistent eating disorders. However, many individuals experience ongoing psychiatric issues and unemployment 18 years after onset.
Area of Science:
- Psychiatry
- Longitudinal Studies
- Eating Disorders
Background:
- Long-term outcomes of anorexia nervosa require further investigation.
- Teenage-onset anorexia nervosa has specific long-term implications.
- Understanding prognosis is crucial for effective treatment.
Purpose of the Study:
- To prospectively examine the 18-year outcome of teenage-onset anorexia nervosa.
- To identify prognostic factors influencing long-term recovery.
- To compare outcomes in a representative sample with matched controls.
Main Methods:
- Prospective cohort study of 51 individuals with teenage-onset anorexia nervosa and 51 controls.
- Assessment at ages 16, 21, and 24 years, with a final follow-up at mean age 32.
- Utilized structured interviews for psychiatric disorders and functional outcomes (Morgan-Russell, GAF).
Main Results:
- No mortality observed in the anorexia nervosa group over 18 years.
- 12% experienced persistent eating disorders; 39% had other psychiatric disorders.
- 12% had poor overall outcomes, with 25% unemployed due to psychiatric issues.
Conclusions:
- Teenage-onset anorexia nervosa has a favorable 18-year prognosis concerning mortality and persistent eating disorders.
- Premorbid obsessive-compulsive personality disorder, age at onset, and autistic traits predict poorer outcomes.
- While mortality is low, significant psychiatric comorbidity and functional impairment persist for some individuals.
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