The British Journal of Psychiatry (2009) 194: 168-174. doi: 10.1192/bjp.bp.107.048686
© 2009 The Royal College of Psychiatrists
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Adolescent-onset anorexia nervosa: 18-year outcome

Elisabet Wentz, MD, PhD

Institute of Neuroscience and Physiology, Child and Adolescent Psychiatry, Göteborg University, and Vårdal Institute, Swedish Institute for Health Sciences, Sweden

I. Carina Gillberg, MD, PhD

Institute of Neuroscience and Physiology, Child and Adolescent Psychiatry, Göteborg University, Sweden

Henrik Anckarsäter, MD, PhD

Institute of Clinical Sciences, Lund University, Malmö, Sweden

Christopher Gillberg, MD, PhD

Institute of Neuroscience and Physiology, Child and Adolescent Psychiatry, Göteborg University, Sweden, and Department of Child and Adolescent Psychiatry, Strathclyde University, Glasgow, UK

Maria Råstam, MD, PhD

Institute of Neuroscience and Physiology, Child and Adolescent Psychiatry, Göteborg University, and Institute of Clinical Sciences, Child and Adolescent Psychiatry, Lund University, Lund, Sweden

Correspondence: Dr Elisabet Wentz, Institute of Neuroscience and Physiology, Child and Adolescent Psychiatry, Göteborg University, Otterhällegatan 12 B, SE–411 18 Göteborg, Sweden. Email: elisabet.wentz{at}vgregion.se

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

The long-term outcome of anorexia nervosa is insufficiently researched.

Aims

To study prospectively the long-term outcome and prognostic factors in a representative sample of people with teenage-onset anorexia nervosa.

Method

Fifty-one people with anorexia nervosa, recruited by community screening and with a mean age at onset of 14 years were compared with 51 matched comparison individuals at a mean age of 32 years (18 years after disorder onset). All participants had been examined at ages 16 years, 21 years and 24 years. They were interviewed for Axis I psychiatric disorders and overall outcome (Morgan–Russell assessment schedule and the Global Assessment of Functioning).

Results

There were no deaths. Twelve per cent (n=6) had a persisting eating disorder, including three with anorexia nervosa. Thirty-nine per cent of the anorexia nervosa group met the criteria for at least one psychiatric disorder. The general outcome was poor in 12%. One in four did not have paid employment owing to psychiatric problems. Poor outcome was predicted by premorbid obsessive–compulsive personality disorder, age at onset of anorexia nervosa and autistic traits.

Conclusions

The 18-year outcome of teenage-onset anorexia nervosa is favourable in respect of mortality and persisting eating disorder.


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Adolescent onset anorexia nervosa- Missing half of the story?
Murali K Sekar
BJP Online, 25 Feb 2009 [Full text]
Re: Adolescent onset anorexia nervosa- Missing half of the story?
Elisabet Wentz, et al.
BJP Online, 18 Mar 2009 [Full text]