Twelve-year course and outcome predictors of anorexia nervosa
Twelve-year course and outcome predictors of anorexia nervosa
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DOI：
10.1002/eat.20215
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发表时间：
2006-03-01
影响因子：
5.5
通讯作者：
Hedlund, S
中科院分区：
文献类型：
--
作者：
Fichter, MM;Quadflieg, N;Hedlund, S
目的：本研究展示了根据第四版标准诊断的 103 名患者的大样本中超过 12 年的神经性厌食症 (AN) 长期病程。方法：在治疗开始、治疗结束、2年随访、6年随访和12年随访时进行评估。获得了自我评分和专家评分访谈数据。结果：12年随访的参与率为存活者的88%。治疗期间有显着改善，治疗后头 2 年有中度（在许多情况下不显着）下降，治疗后 3 至 12 年进一步改善。根据全球 12 年结局评分，27.5% 的结局良好，25.3% 的结局中等，39.6% 的结局较差，7 人（7.7%）死亡。在 12 年的随访中，19.0% 的人患有 AN，9.5% 的人患有神经性贪食症清除型 (BN-P)，19.0% 的人被归类为未另行指定的饮食失调 (EDNOS)。总共 52.4% 的人没有表现出严重的 DSM-IV 饮食失调，0% 的人患有暴食症 (BED)。系统性、严格基于经验的模型构建产生了一个简洁的模型，其中包括四个 12 年不良结果的预测因子，解释了 45% 的方差，即性问题、冲动、住院治疗时间长和饮食失调持续时间长。结论：死亡率很高，症状恢复时间较长。冲动性、症状严重程度和长期性是预测 12 年结果的重要因素。 (c) 2005 年，Wiley periodicals, Inc.
Objective: The current study presents the long-term course of anorexia nervosa (AN) over 12 years in a large sample of 103 patients diagnosed according to criteria in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).Method: Assessments were made at the beginning of therapy, at the end of therapy, at the 2-year follow-up, at the 6-year follow-up, and at the 12-year follow-up. Self-rating and an expert-rating interview data were obtained.Results: The participation rate at the 12-year follow-up was 88% of those alive. There was substantial improvement during therapy, a moderate (in many instances nonsignificant) decline during the first 2 years posttreatment, and further improvement from 3 to 12 years posttreatment. Based on a global 12-year outcome score, 27.5% had a good outcome, 25.3% an intermediate outcome, 39.6% had a poor outcome, and 7 (7.7%) were deceased. At the 12-year follow-up 19.0% had AN, 9.5% had bulimia nervosa-purging type (BN-P), 19.0% were classified as eating disorder not otherwise specified (EDNOS). A total of 52.4% showed no major DSM-IV eating disorder and 0% had binge eating disorder (BED). Systematic-strictly empirically based-model building resulted in a parsimonious model including four predictors of unfavorable 12-year outcome explaining 45% of the variance, that is, sexual problems, impulsivity, long duration of inpatient treatment, and long duration of an eating disorder.Conclusion: Mortality was high and symptomatic recovery protracted. Impulsivity, symptom severity, and chronicity were the important factors for predicting the 12-year outcome. (c) 2005 by Wiley Periodicals, Inc.