Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Hauptstrasse 8, D-79104 Freiburg.
J Clin Psychol. 2011 Mar;67(3):318-27. doi: 10.1002/jclp.20766. Epub 2011 Jan 3.
We report on the 3-year course and outcome of patients with bulimia nervosa (BN), initially treated in an inpatient or day clinic setting. Patients were assessed by structured interviews (Structured Clinical Interview for DSM Disorders I and II and Structured Interview for Anorexia and Bulimia Nervosa) and questionnaires (Eating Disorder Inventory-2, Symptom Checklist-90-R, and Social Adjustment Scale) at time points of admission, discharge, and 3-month, 12-month and 36-month follow-ups. Data of 83.7% of the 43 patients were available. After 3 years, about one third of patients showed complete remission, one third showed partial remission, and one third still fulfilled all the criteria of BN. Most changes occurred during hospitalization. Remission status showed substantial fluctuation over time, with little correlation between time points of assessment (discharge and 3-month, 12-month, and 36-month follow-ups). A cluster analysis revealed four patterns of longitudinal symptom change. Day clinic and inpatient treatment are overall effective. Longitudinal and repeated assessments are necessary to validly measure outcome in BN.
我们报告了 43 名神经性贪食症（BN）患者的 3 年病程和结局，这些患者最初在住院或日间诊所接受治疗。患者在入院、出院时以及 3、12 和 36 个月随访时接受了结构化访谈（DSM 障碍 I 和 II 型结构化临床访谈和神经性贪食症结构化访谈）和问卷（饮食障碍问卷-2、症状检查表-90-R 和社会适应量表）评估。43 名患者中有 83.7%的数据可用。3 年后，约三分之一的患者完全缓解，三分之一部分缓解，三分之一仍符合 BN 的所有标准。大多数变化发生在住院期间。缓解状态随时间有很大波动，评估时间点之间相关性较小（出院和 3、12 和 36 个月随访）。聚类分析显示出四种纵向症状变化模式。日间诊所和住院治疗总体有效。BN 中需要进行纵向和重复评估以有效衡量结局。
