Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-22T08:21:14.476Z Has data issue: false hasContentIssue false
  • English
  • Français

Anorexia Nervosa: Outcome and Prognostic Factors after 20 Years

Published online by Cambridge University Press:  03 January 2018

R. H. Ratnasuriya ,
I. Eisler ,
G. I. Szmukler  and
G. F. M. Russell
R. H. Ratnasuriya
Affiliation:
The Acre Day Hospital, Worthing, Sussex
I. Eisler
Affiliation:
Institute of Psychiatry, and Principal Clinical Psychologist, Bethlem Royal and Maudsley Hospital, London
G. I. Szmukler
Affiliation:
Royal Melbourne Hospital, Parkville, Victoria, Australia
G. F. M. Russell*
Affiliation:
Institute of Psychiatry and Bethlem Royal and Maudsley Hospital, London
*
∗Institute of Psychiatry, De Crespigny Park, London SE5 8AF
Get access Rights & Permissions [Opens in a new window]

Abstract

Forty-one patients with anorexia nervosa, admitted to the Maudsley Hospital between 1959 and 1966, were followed up after a mean of 20 years. An assessment of general outcome (based on the Morgan-Russell scales) yielded three outcome categories: ‘good’ (n = 12), ‘intermediate’ (n = 13) and ‘poor’ (n = 15). Six patients (15%) had died from causes related to anorexia nervosa; at least 15% had developed bulimia nervosa. There was a general consistency between the follow-up at 20 years and that previously conducted five years after admission, although with a few individual patients there were serious prognostic errors at the earlier follow-up. A poorer outcome was associated with a later age of onset, a history of neurotic and personality disturbances, disturbed relationships in the family and a longer duration of illness.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 158 , Issue 4 , April 1991 , pp. 495 - 502
Copyright
Copyright © Royal College of Psychiatrists, 1991 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†

We announce with regret the death of Dr Harsha Ratnasuriya on the 24th February 1989, after he had completed the patient follow-up.

References

Bryant-Waugh, R., Knibbs, J., Fosson, A., et al (1988) Long-term follow up of patients with early onset anorexia nervosa. Archives of Disease in Childhood, 63, 5–9.Google Scholar
Dally, P. (1969) Anorexia Nervosa. London: Heinemann.Google Scholar
Farquharson, R. F. & Hyland, H. H. (1966) Anorexia nervosa: the course of 15 patients treated from 20 to 30 years previously. Journal of Canadian Medical Association, 94, 411–419.Google ScholarPubMed
Garfinkel, P. E. & Garner, D. M. (1982) Anorexia Nervosa – a Multidimensional Perspective. New York: Alan Liss.Google Scholar
Halmi, K. (1988) The course and outcome of eating disorders. Paper presented at the 3rd International Conference on Eating Disorders, New York.Google Scholar
Halmi, K., Brodland, G. & Rioas, C. (1975) A follow-up study of seventy-nine patients with anorexia nervosa: an evaluation of prognostic factors and diagnostic criteria. Life History Research in Psychopathology, 4, 290–301.Google Scholar
Hsu, L. K. G. (1980) Outcome of anorexia nervosa. A review of the literature (1954–1978). Archives of General Psychiatry, 37, 1040–1046.Google Scholar
Hsu, L. K. G., Crisp, A. H. & Harding, H. (1979) Outcome of anorexia nervosa. Lancet, i, 61–65.CrossRefGoogle ScholarPubMed
Isager, T., Brinch, M., Kreiner, S., et al (1985) Death and relapse in anorexia nervosa: survival analysis of 151 cases. Journal of Psychiatric Research, 19, 515–521.Google Scholar
Kalbfleisch, J. D. & Prentice, R. L. (1980) The Statistical Analysis of Failure Time Data. New York: Wiley.Google Scholar
Morgan, H. G. (1973) Anorexia nervosa: a prognostic study. MD Thesis. Cambridge: University of Cambridge.Google Scholar
Morgan, H. G. & Russell, G. F. M. (1975) Value of family background and clinical features as predictors of long-term outcome in anorexia nervosa: four year follow-up study of 41 patients. Psychological Medicine, 5, 355–371.CrossRefGoogle ScholarPubMed
Morgan, H. G. & Hayward, A. E. (1988) Clinical assessment of anorexia nervosa: the Morgan-Russell outcome assessment schedule. British Journal of Psychiatry, 152, 367–371.CrossRefGoogle ScholarPubMed
Morgan, H. G., Purgold, J. & Wellbourne, J. (1983) Management and outcome in anorexia nervosa: a standardised prognostic study. British Journal of Psychiatry, 143, 282–287.CrossRefGoogle ScholarPubMed
Ratnasuriya, R. H. (1986) Prognostic factors and outcome after 20 years in anorexia nervosa. MPhil Thesis. London: University of London.Google Scholar
Russell, G. F. M. (1970) Anorexia nervosa – its identity as an illness and its treatment. In Modern Trends in Psychological Medicine Vol. 2 (ed. J. H. Price). London: Butterworth.Google Scholar
Russell, G. F. M. (1977) General management of anorexia nervosa and difficulties in assessing the efficacy of treatment. In Anorexia Nervosa (ed. R. A. Vigersky). New York: Raven Press.Google Scholar
Russell, G. F. M. (1979) Bulimia nervosa: an ominous variant of anorexia nervosa. Psychological Medicine, 9, 429–448.CrossRefGoogle ScholarPubMed
Russell, G. F. M., Szmukler, G. I., Dare, C., et al (1987) An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Archives of General Psychiatry, 44, 1047–1056.Google Scholar
Schwartz, D. M. & Thompson, M. G. (1981) Do anorectics get well? Current research and future needs. American Journal of Psychiatry, 138, 319–323.Google ScholarPubMed
Society Of Actuaries (1959) Build and Blood Pressure Study, Vol. 1. Reprinted (1970) Documenta Geigy: Scientific Tables (7th edn). Basle: J. R. Geigy.Google Scholar
Steinhausen, H-L. & Glanville, K. (1983) Follow-up studies of anorexia nervosa: a review of research findings. Psychological Medicine, 13, 239–249.Google Scholar
Swift, W. (1982) The long-term outcome of early onset anorexia nervosa – a critical review. Journal of the American Academy of Child Psychiatry, 21, 38–58.Google Scholar
Theander, S. (1970) Anorexia nervosa. A psychiatric investigation of 94 female cases. Acta Psychiatrica Scandinavica, 214 (suppl.) 1–194.Google Scholar
Theander, S. (1985) Outcome and prognosis in anorexia nervosa and bulimia: some results of previous investigations, compared with those of a Swedish long-term study. Journal of Psychiatric Research, 19, 493–508.Google Scholar
Tolstrup, K., Brinch, M., Isagen, T., et al (1985) Long-term outcome of 151 cases of anorexia nervosa. Acta Psychologica Scandinavica, 71, 380–387.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.