Herzog D B, Dorer D J, Keel P K, Selwyn S E, Ekeblad E R, Flores A T, Greenwood D N, Burwell R A, Keller M B
Harvard Medical School, Boston, USA.
J Am Acad Child Adolesc Psychiatry. 1999 Jul;38(7):829-37. doi: 10.1097/00004583-199907000-00012.
To assess the course and outcome of anorexia nervosa (AN) and bulimia nervosa (BN) at a median of 90 months of follow-up in a large cohort of women with eating disorders.
A prospective, naturalistic, longitudinal design was used to map the course of AN and BN in 246 women. Follow-up data are presented in terms of full and partial recovery, predictors of time to recovery, and rates and predictors of relapse.
The full recovery rate of women with BN was significantly higher than that of women with AN, with 74% of those with BN and 33% of those with AN achieving full recovery by a median of 90 months of follow-up. Intake diagnosis of AN was the strongest predictor of worse outcome. No predictors of recovery emerged among bulimic subjects. Eighty-three percent of women with AN and 99% of those with BN achieved partial recovery. Approximately one third of both women with AN and women with BN relapsed after full recovery. No predictors of relapse emerged.
The findings suggest that the course of AN is characterized by high rates of partial recovery and low rates of full recovery, while the course of BN is characterized by higher rates of both partial and full recovery.
在一大群饮食失调女性中，对神经性厌食症（AN）和神经性贪食症（BN）进行为期90个月的中位随访，以评估其病程及转归。
采用前瞻性、自然主义的纵向设计，对246名女性的AN和BN病程进行追踪。随访数据包括完全康复和部分康复情况、康复时间的预测因素以及复发率和复发预测因素。
BN女性的完全康复率显著高于AN女性，在90个月的中位随访期内，74%的BN患者和33%的AN患者实现了完全康复。AN的初诊是预后较差的最强预测因素。在贪食症患者中未发现康复的预测因素。83%的AN女性和99%的BN女性实现了部分康复。AN女性和BN女性中约有三分之一在完全康复后复发。未发现复发的预测因素。
研究结果表明，AN病程的特点是部分康复率高而完全康复率低，而BN病程的特点是部分康复率和完全康复率均较高。
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