Abstract
The current study describes the short-term outcome of adolescent inpatient population suffering from anorexia nervosa (AN) and analyzes the clinical predictors of poor outcome in these patients. Fifty-seven female AN patients (mean = 15.8, SD = 1.3) admitted for inpatient treatment to a specialized eating disorder unit at a university medical center were reassessed 1 year after being discharged. Assessments were made at the beginning and at the end of the inpatient treatment as well as at the 1-year follow-up. Self-rating data and expert-rating interview data were obtained. Adequate data for 55 (96.5%) cases allowed for the assignment of an outcome category. A total of 28.1% of the patients’ cases showed a good outcome, meaning the patients fully recovered, and 8.8% had an intermediate outcome, and 59.6% of the patients’ cases had a poor outcome. Significant predictors of poor outcome included the patient’s BMI at the beginning of the treatment as well as psychiatric comorbidity, and purging behavior. Adolescent AN is a severe disorder with a poor outcome in a substantial amount of adolescents.
References
American Psychiatric Association (1994) Diagnostic and statistical manual for mental disorders. American Psychiatric Association, Washington, DC
Castro J, Gila A, Puig J, Rodriguez S, Toro J (2004) Predictors of rehospitalization after total weight recovery in adolescents with anorexia nervosa. Int J Eat Disord 36:22–30
Couturier J, Lock J (2006) What is remission in adolescent anorexia nervosa? A review of various conceptualizations and quantitative analysis. Int J Eat Disord 39:175–183
Deter HC, Schellberg D, Kopp W, Friederich HC, Herzog W (2005) Predictability of a favorable outcome in anorexia nervosa. Eur Psychiatry 20:165–172
Eckert ED, Halmi KA, Marchi P, Grove W, Crosby R (1995) Ten-year follow-up of anorexia nervosa: clinical course and outcome. Psychol Med 25:143–156
Eisler I, Dare C, Hodes M, Russell G, Dodge E, le Grange D (2000) Family therapy for adolescent anorexia nervosa: the results of a controlled comparison of two family interventions. J Child Psychol Psychiatry 41:727–736
Eisler I, Dare C, Russell GF, Szmukler G, le Grange D, Dodge E (1997) Family and individual therapy in anorexia nervosa. A 5-year follow-up. Arch Gen Psychiatry 54:1025–1030
Fichter M, Quadflieg N (2001) The structured interview for anorexic and bulimic disorders for DSM-IV and ICD-10 (SIAB-EX): reliability and validity. Eur Psychiatry 16:38–48
Fichter MM, Herpertz S, Quadflieg N, Herpertz-Dahlmann B (1998) Structured Interview for Anorexic and Bulimic disorders for DSM-IV and ICD-10: updated (third) revision. Int J Eat Disord 24:227–249
Fichter MM, Quadflieg N, Hedlund S (2006) Twelve-year course and outcome predictors of anorexia nervosa. Int J Eat Disord 39:87–100
Franke GH (2002) SCL-90-R - Die Symptomcheckliste von L. R. Derogatis. Huber, Bern
Gowers SG (2008) Management of eating disorders in children and adolescents. Arch Dis Child 93:331–334
Gowers SG, Clark A, Roberts C, Griffiths A, Edwards V, Bryan C, Smethurst N, Byford S, Barrett B (2007) Clinical effectiveness of treatments for anorexia nervosa in adolescents: randomised controlled trial. Br J Psychiatry 191:427–435
Herpertz-Dahlmann B, Muller B, Herpertz S, Heussen N, Hebebrand J, Remschmidt H (2001) Prospective 10-year follow-up in adolescent anorexia nervosa–course, outcome, psychiatric comorbidity, and psychosocial adaptation. J Child Psychol Psychiatry 42:603–612
Herzog DB, Dorer DJ, Keel PK, Selwyn SE, Ekeblad ER, Flores AT, Greenwood DN, Burwell RA, Keller MB (1999) Recovery and relapse in anorexia and bulimia nervosa: a 7.5-year follow-up study. J Am Acad Child Adolesc Psychiatry 38:829–837
le Grange D (1999) Family therapy for adolescent anorexia nervosa. J Clin Psychol 55:727–739
Lock J, Agras WS, Bryson S, Kraemer HC (2005) A comparison of short- and long-term family therapy for adolescent anorexia nervosa. J Am Acad Child Adolesc Psychiatry 44:632–639
Lowe B, Zipfel S, Buchholz C, Dupont Y, Reas DL, Herzog W (2001) Long-term outcome of anorexia nervosa in a prospective 21-year follow-up study. Psychol Med 31:881–890
Morgan HG, Hayward AE (1988) Clinical assessment of anorexia nervosa. The Morgan-Russell outcome assessment schedule. Br J Psychiatry 152:367–371
Rathner G, Waldherr K (1997) Eating Disorder Inventory-2: Eine deutschsprachige Validierung mit Normen für weibliche und männliche Jugendliche. Z Klin Psychol Psychiatr Psychother 45:157–182
Ratnasuriya RH, Eisler I, Szmukler GI, Russell GF (1991) Anorexia nervosa: outcome and prognostic factors after 20 years. Br J Psychiatry 158:495–502
Russell GF, Szmukler GI, Dare C, Eisler I (1987) An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Arch Gen Psychiatry 44:1047–1056
Steinhausen HC (2002) The outcome of anorexia nervosa in the 20th century. Am J Psychiatry 159:1284–1293
Steinhausen HC (1997) Outcome of anorexia nervosa in the younger patient. J Child Psychol Psychiatry 38:271–276
Steinhausen HC, Grigoroiu-Serbanescu M, Boyadjieva S, Neumarker KJ, Winkler Metzke C (2008) Course and predictors of rehospitalization in adolescent anorexia nervosa in a multisite study. Int J Eat Disord 41:29–36
Lievers LS, Curt F, Wallier J, Perdereau F, Rein Z, Jeammet P, Godart N (2008) Predictive factors of length of inpatient treatment in anorexia nervosa. Eur Child Adolesc Psychiatry 18(2):75–84
Strober M, Freeman R, Morrell W (1997) The long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse, and outcome predictors over 10–15 years in a prospective study. Int J Eat Disord 22:339–360
Willer MG, Thuras P, Crow SJ (2005) Implications of the changing use of hospitalization to treat anorexia nervosa. Am J Psychiatry 162:2374–2376
Wittchen HU (1994) Reliability and validity studies of the WHO–Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res 28:57–84
Wittchen HU, Pfister H (1997) Instruktionsmanual zur Durchführung von DIA-X Interviews. Swets & Zeitlinger Press, Frankfurt
Acknowledgment
This project was funded by the Stiftung RTL- Wir helfen Kindern e.V. The authors wish to thank the adolescents who participated in the project.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Salbach-Andrae, H., Schneider, N., Seifert, K. et al. Short-term outcome of anorexia nervosa in adolescents after inpatient treatment: a prospective study. Eur Child Adolesc Psychiatry 18, 701–704 (2009). https://doi.org/10.1007/s00787-009-0024-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00787-009-0024-9