Wentz Elisabet, Gillberg I Carina, Anckarsäter Henrik, Gillberg Christopher, Råstam Maria
Institute of Neuroscience and Physiology, Child and Adolescent Psychiatry, Göteborg University, Otterhällegatan 12 B, SE-411 18 Göteborg, Sweden.
Br J Psychiatry. 2009 Feb;194(2):168-74. doi: 10.1192/bjp.bp.107.048686.
The long-term outcome of anorexia nervosa is insufficiently researched.
To study prospectively the long-term outcome and prognostic factors in a representative sample of people with teenage-onset anorexia nervosa.
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).
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.
The 18-year outcome of teenage-onset anorexia nervosa is favourable in respect of mortality and persisting eating disorder.
神经性厌食症的长期预后研究尚不充分。
前瞻性研究青少年起病的神经性厌食症患者代表性样本的长期预后及预后因素。
通过社区筛查招募了51名神经性厌食症患者，其发病时的平均年龄为14岁，并将其与51名匹配的对照个体进行比较，这些对照个体的平均年龄为32岁（疾病发作后18年）。所有参与者在16岁、21岁和24岁时均接受了检查。对他们进行了关于轴I精神障碍和总体预后的访谈（摩根-拉塞尔评估量表和功能总体评估）。
无死亡病例。12%（n = 6）患有持续性饮食失调，其中3例为神经性厌食症。39%的神经性厌食症组符合至少一种精神障碍的标准。12%的总体预后较差。四分之一的人由于精神问题没有带薪工作。病前强迫型人格障碍、神经性厌食症发病年龄和自闭症特征可预测预后不良。
青少年起病的神经性厌食症18年的预后在死亡率和持续性饮食失调方面是良好的。
