Duration of Untreated Eating Disorder and Prodrome in Young People: Characteristics and Relationship to Early...

Eating disorders (EDs) are serious illnesses and a better understanding of initial symptom phases could inform early intervention. This study aims to evaluate duration of untreated eating disorder (DUED) and duration/characteristics of the preceding prodrome period in young people diagnosed with an ED.

Fifty-four young people (28 adolescents aged 13-17 and 26 emerging adults aged 18-25) with recent onset EDs (< 3 years) completed a retrospective onset interview and life chart. DUED, prodrome duration and prodrome characteristics (ED-specific and more broad psychiatric symptoms) were compared according to developmental stage and diagnosis. The relationships between DUED and prodrome duration with early outcomes were evaluated.

Emerging adults had a longer DUED than adolescents. This group also had a longer prodrome but only when broad psychiatric symptoms (i.e., not ED-specific) were considered. Those with bulimia-type EDs had a longer ED-specific and broad psychiatric prodrome compared to those with anorexia-type EDs. There were no significant developmental stage or diagnosis-related differences in symptom severity during prodrome. In those who were underweight at presentation to services, a shorter broad prodrome duration was associated with greater weight gain after 3 months of treatment.

When both ED and broad psychiatric symptoms are considered, DUED and prodromal symptoms of EDs differ according to developmental stage and diagnosis. Duration of prodrome may also impact early outcomes but further research is needed.