Willi J, Hagemann R
Schweiz Med Wochenschr. 1976 Oct 23;106(43):1459-65.
A follow-up study has been recently conducted in 20 female patients with severe anorexia nervosa who had undergone stationary psychotherapeutic treatment at our clinic 8-16 years ago. Whilst according to our findings the prognosis for anorexia nervosa still remains poor, it does not seem quite so hopeless as is frequently presumed. Out of the 20 patients followed up, 5 now have chronic anorexia nervosa and in 2 cases transition to an endogenous psychosis has occurred (schizophrenia simplex with chronified anorexia in one, and endogenous depression after improvement of anorexia in the other case). 1 patient died in the interval between observations as a result of her anorexia. The general results of our investigation roughly confirm the rule-of-thumb predictions for many psychotherapeutic treatments of neurotic diseases, i.e. 1/3 unimproved, 1/3 improved, 1/3 cured. Although free from illness, the majority of the patients must be described as conspicuous within the norm. The typical personal characteristics of the anorectic are maintained, their weight remains below normal level, and they suffer from eating problems. According to our investigation a positive prognosis correlates with onset of the illness before the age of 18, absence of laxative abuse, and subsequent marriage, whereas premature interruption of the treatment with return to the parental home proves to have a negative effect. In apparent contradiction to the persistence of the characteristic anorectic features is the evidence that out of the 20 patients in question 12 married and 8 had children. On the other hand, the fact that during the interval between observations 4 patients relapsed into severe anorexia in connexion with engagement or pregnancy indicates that acceptance of a mature female or maternal role often remains a problem. Of gynecologic interest is the fact that long-lasting secondary amenorrhea (up to 10 years, with an average of 5 years) has not led to fertility problems for any of the married patients who wanted children.
最近对20名患有严重神经性厌食症的女性患者进行了一项随访研究，这些患者在8至16年前曾在我们诊所接受过住院心理治疗。根据我们的研究结果，神经性厌食症的预后仍然很差，但似乎并不像人们通常认为的那样毫无希望。在接受随访的20名患者中，5人目前患有慢性神经性厌食症，2人已转变为内源性精神病（1例为单纯型精神分裂症伴慢性化厌食症，另1例为厌食症改善后出现内源性抑郁症）。1名患者在观察期间因厌食症死亡。我们调查的总体结果大致证实了许多神经症疾病心理治疗的经验性预测，即三分之一未改善，三分之一有所改善，三分之一治愈。尽管已无疾病，但大多数患者在正常范围内仍较为显眼。厌食症患者的典型个人特征依然存在，体重仍低于正常水平，且存在饮食问题。根据我们的调查，积极的预后与18岁前发病、无滥用泻药以及随后结婚相关，而治疗过早中断并回到父母家中则被证明有负面影响。与厌食症特征持续存在明显矛盾的是，在所研究的20名患者中，有12人结婚，8人育有子女。另一方面，在观察期间有4名患者因订婚或怀孕而复发为严重厌食症，这一事实表明接受成熟女性或母亲角色往往仍是一个问题。从妇科角度来看，一个有趣的事实是，长期继发性闭经（长达10年，平均5年）并未给任何想要孩子的已婚患者带来生育问题。
