Outcome and Prognosis of Anorexia Nervosa

1990 ◽  
Vol 156 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Jan H. Rosenvinge ◽  
Sven O. Mouland
Keyword(s):  
Anorexia Nervosa ◽  
Social Withdrawal ◽  
Family Relations ◽  
Psychiatric Ward ◽  
Semistructured Interview ◽  
Prognostic Variables ◽  
Psychiatric Status ◽  
Duration Of Illness ◽  
Outcome Criteria

An investigation was carried out in 1986 of 41 patients, 39 female and 2 male, who had been treated for anorexia nervosa in a psychiatric ward at a general hospital between 1958 and 1980. A follow-up analysis was carried out, in which 30 subjects participated. Using the scores on the 40-item version of the EAT as outcome criteria, validated by the Morgan–Hayward outcome scales, the outcome distribution and rate of mortality was in agreement with previous findings. Further data concerning weight, menstruation, and nutritional, social and psychiatric status were based on a semistructured interview as well as on the scores on the EAT, the GHQ, and the MMPI. Prognostic variables were analysed, indicating that duration of illness, poor motivation for treatment, social withdrawal, and poor family relations were significant as predictors of poor outcome.

Anorexia Nervosa: Outcome and Prognostic Factors after 20 Years

1991 ◽  
Vol 158 (4) ◽  
pp. 495-502 ◽  
Author(s):  
R. H. Ratnasuriya ◽  
I. Eisler ◽  
G. I. Szmukler ◽  
G. F. M. Russell
Keyword(s):  
Anorexia Nervosa ◽  
Prognostic Factors ◽  
Bulimia Nervosa ◽  
Age Of Onset ◽  
Duration Of Illness ◽  
General Outcome ◽  
The Family ◽  
History Of ◽  
Disturbed Relationships

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.

Management and Outcome in Anorexia Nervosa

1983 ◽  
Vol 143 (3) ◽  
pp. 282-287 ◽  
Author(s):  
H. G. Morgan ◽  
Joan Purgold ◽  
Jill Welbourne
Keyword(s):  
Anorexia Nervosa ◽  
Evaluation Procedure ◽  
Factors Associated ◽  
Poor Outcome ◽  
Duration Of Illness ◽  
Long Duration ◽  
Special Clinic ◽  
Chronic Morbidity

SummaryThe outcome of 78 patients with anorexia nervosa treated in a special clinic is described, using a standardized follow-up technique. The findings are compared with two previous studies which utilized an identical evaluation procedure. Certain predictors of poor outcome already identified by previous studies (long duration of illness before referral, previous personality problems, difficulties in relationship between family and patient) are confirmed. The findings suggest that early intervention may be an important component of effective treatment. The possible advantages of long term continuity of outpatient care are also discussed and the need for careful scrutiny of criteria for hospital admission emphasized.It is concluded that chronic morbidity due to anorexia nervosa represents an important topic for further research. There is need for further identification of factors associated with chronicity, some of which may be secondary repercussions of the illness itself, and prospective evaluation of treatment programmes which focus on predictors of poor outcome.

Family Therapy Outcome in Adolescent Anorexia Nervosa

1993 ◽  
Vol 23 (4) ◽  
pp. 174-179 ◽  
Author(s):  
Daniel le Grange
Keyword(s):  
Anorexia Nervosa ◽  
Family Therapy ◽  
Controlled Trial ◽  
Psychological Treatments ◽  
Duration Of Illness ◽  
Long Term Follow Up ◽  
Adolescent Anorexia Nervosa ◽  
Methods Of Treatment

Anorexia nervosa is a serious psychosomatic illness which often follows a prolonged course. Recent long-term follow-up studies have indicated high mortality rates. It is therefore necessary to search for effective methods of treatment which could improve the outcome in anorexia nervosa. One controlled trial which evaluated the efficacy of different forms of psychological treatments has shown that family therapy is the superior treatment for patients with an early onset and short duration of illness. In this article I review the development of family therapy for anorexia nervosa with specific emphasis on the controlled family treatment studies at the Maudsley Hospital in London. The efficacy of outpatient family therapy for weight restitution in malnourished anorexia nervosa patients, and some effective ingredients of this treatment approach, are discussed.

Further Investigation of the Predictors of Outcome Following First Schizophrenic Episodes

1990 ◽  
Vol 157 (2) ◽  
pp. 182-189 ◽  
Author(s):  
Eve C. Johnstone ◽  
J. Fiona Macmillan ◽  
Christopher D. Frith ◽  
Desmond K. Benn ◽  
Timothy J. Crow
Keyword(s):  
Mental State ◽  
Treatment Duration ◽  
Social Withdrawal ◽  
Predictors Of Outcome ◽  
Occupational Outcome ◽  
Duration Of Illness ◽  
Pre Treatment ◽  
Social Presentation ◽  
First Admission

The outcome at two years of patients who were eligible for a study of first schizophrenic episodes was assessed in terms of occupation (n = 237) and in terms of number of days spent as an in-patient from the time of first admission (n = 252), and was related to social, behavioural, mental state and neurological measures during the initial admission. Poor outcome was in general associated with more social withdrawal, inactivity and abnormal social presentation and with more ‘neurological soft signs'. Good occupational outcome in patients with a relatively short pre-treatment duration of illness was associated with the prescription of placebo medication during the follow-up period.

scholarly journals Predictors of illness course and health maintenance following inpatient treatment among patients with anorexia nervosa

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Deborah R. Glasofer ◽  
Alexandra F. Muratore ◽  
Evelyn Attia ◽  
Peng Wu ◽  
Yuanjia Wang ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Inpatient Treatment ◽  
Weight Status ◽  
Self Report ◽  
Healthy Weight ◽  
Health Maintenance ◽  
Duration Of Illness ◽  
Clinical Impairment

Abstract Background Anorexia nervosa (AN) is a life-threatening psychiatric disorder associated with significant medical and psychosocial impairment. Hospital-based behavioral treatment is an effective intervention in the short-term. However, relapse rates following discharge are high and thus, there is a need to identify predictors of longitudinal outcome. The current study provides information regarding illness course and health maintenance among patients with AN over 5 years following discharge from an eating disorder inpatient unit. Methods Participants were individuals with AN who were discharged from a specialized, inpatient behaviorally-based unit. Prior to discharge, height and weight were measured and participants completed self-report measures of eating disorder severity and general psychopathology (depression, anxiety, harm avoidance). Participants were contacted annually for self-report measures of weight, eating disorder severity and clinical impairment. Outcome was defined by illness course (body mass index (BMI) and clinical impairment during the 5 years) and health maintenance (categories of weight and eating disorder symptom severity) across follow-up, using all available data. Linear mixed models were used to examine whether demographic and clinical parameters at discharge predicted BMI and clinical impairment over time. Additional analyses examined whether these variables significantly influenced an individual’s likelihood of maintaining inpatient treatment gains. Results One-hundred and sixty-eight individuals contributed data. Higher trait anxiety at discharge was associated with a lower BMI during follow-up (p = 0.012). There was a significant interaction between duration of illness and time, whereby duration of illness was associated with a faster rate of weight loss (p = 0.003) during follow-up. As duration of illness increased, there was a greater increase in self-reported clinical impairment (p = 0.011). Increased eating disorder severity at discharge was also associated with greater clinical impairment at follow-up (p = 0.004). Higher BMI at discharge was significantly associated with maintaining healthy weight across a priori BMI-based definitions of health maintenance. Conclusions Weight status (higher BMI) and duration of illness are key factors in the prognosis of AN. Higher weight targets in intensive treatments may be of value in improving outcomes.

scholarly journals Cognitive Function in Adults with Enduring Anorexia Nervosa

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 859
Author(s):  
Maria Seidel ◽  
Helen Brooker ◽  
Kamilla Lauenborg ◽  
Keith Wesnes ◽  
Magnus Sjögren
Keyword(s):  
Anorexia Nervosa ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Reaction Times ◽  
Assessment System ◽  
Cognitive Test ◽  
Attention Tasks ◽  
Inclusion Study ◽  
Prospective Longitudinal

Anorexia Nervosa (AN) is a severe and often enduring disorder characterized by restriction of food intake, low body weight, fear of weight gain, and distorted body image. Investigations on cognition performance in AN patients have yielded conflicting results. Using an established and sensitive computerized cognitive test battery, we aimed to assess core aspects of cognitive function, including attention span, information processing, reasoning, working and episodic memory, in AN patients and controls. Patients were recruited from the Danish Prospective Longitudinal all-comer inclusion study in Eating Disorders (PROLED). Included were 26 individuals with AN and 36 healthy volunteers (HV). All were tested with CogTrack (an online cognitive assessment system) at baseline, and AN patients were tested again at a follow-up time point after weight increase (n = 13). At baseline, AN patients showed faster reaction times in the attention tasks, as well as increased accuracy in grammatical reasoning compared to HV. There were no differences in cognitive function between AN patients and HV in the other cognitive domains measured (sustained attention, working and episodic memory, speed of retrieval, and speed of grammatical reasoning). No differences were visible in the AN sample between baseline and follow-up. Performance did not correlate with any clinical variables in the AN sample. These findings supplement results from other studies suggesting increased concentration and reasoning accuracy in patients suffering from AN, who showed increased performance in cognitive tasks despite their illness.

scholarly journals Qualitative study to explore what patients with heart failure find significant during integrated palliative care sessions in a Danish clinic

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e043955
Author(s):  
Stine Gundtoft Roikjær ◽  
Charlotte Paaske Simonÿ ◽  
Helle Ussing Timm
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Meaning Making ◽  
Interview Study ◽  
Exclusion Criterion ◽  
Semistructured Interview ◽  
Patients With Heart Failure ◽  
New Diagnosis ◽  
Medical Perspective

ObjectiveIn the field of palliative care (PC) as it is integrated into heart failure (HF) treatment, it is essential to explore the patient experience and build on this knowledge for the further development of PC practice and policy. Based on an intervention study, this paper explores what patients with HF find significant in integrated sessions using a narrative S’ approach.DesignWe conducted a semistructured interview study with a qualitative analysis focused on meaning making. The study follows the guidelines of Consolidated Criteria for Reporting Qualitative Research.Participants and settingThe inclusion criteria for the PC intervention were (1) a new diagnosis of HF, (2) follow-up treatment at this local Danish HF clinic and (3) informed consent to participate in the integrated PC intervention. The only exclusion criterion was if the patient was already engaged in a PC programme. 20 patients agreed to participate in the intervention, and 12 of these completed the S’ approach sessions and participated in this interview study.ResultsOverall, the analysis showed that the integrated S’ approach sessions were successful in joining an embodied patient perspective with a medical perspective. The thematic analysis resulted in three themes supporting the overall findings: sessions bring comfort, telling your story provides a sense of meaningfulness, and integrating perspectives of HF into everyday life.ConclusionThe method using the S’ approach in integrated PC and HF sessions was significant in various ways. First, patients experienced a calm and safe atmosphere and perceived that the nurse was truly interested in them. Second, the integrated sessions based on the S’ approach were able to bring comfort to lived physical, psychosocial and existential issues. Last, it allowed patients to combine their embodied understanding of HF with a medical perspective, thereby finding meaning in the sense of how everything is connected.

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