Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Department of Applied Psychology, Northeastern University, Boston, MA, USA.
Department of Psychology, Carleton University, Ottawa, Ontario, Canada.
J Psychiatr Res. 2018 Jan;96:183-188. doi: 10.1016/j.jpsychires.2017.10.008. Epub 2017 Oct 16.
The objective of this study was to investigate predictors of long-term recovery from eating disorders 22 years after entry into a longitudinal study.
One hundred and seventy-six of the 228 surviving participants (77.2%) were re-interviewed 20-25 years after study entry using the Longitudinal Interval Follow-up Evaluation to assess ED recovery. The sample consisted of 100 women diagnosed with anorexia nervosa (AN) and 76 with bulimia nervosa (BN) at study entry.
A comorbid diagnosis of major depression at the start of the study strongly predicted having a diagnosis of AN-Restricting type at the 22-year assessment. A higher body mass index (BMI) at study intake decreased the odds of being diagnosed with AN-Binge Purge type, relative to being recovered, 22 years later. The only predictor that increased the likelihood of having a diagnosis of BN at the 22-year assessment was the length of time during the study when the diagnostic criteria for BN were met.
Together, these results indicate that the presence and persistence of binge eating and purging behaviors were poor prognostic indicators and that comorbidity with depression is particularly pernicious in AN. Treatment providers might pay particular attention to these issues in an effort to positively influence recovery over the long-term.
本研究旨在探讨 22 年前进入纵向研究的进食障碍患者长期康复的预测因素。
在研究开始后 20-25 年，使用纵向间隔随访评估对 228 名幸存参与者中的 176 名（77.2%）进行重新访谈，以评估 ED 康复情况。样本包括 100 名在研究开始时被诊断为神经性厌食症（AN）的女性和 76 名被诊断为神经性贪食症（BN）的女性。
研究开始时存在重性抑郁障碍的合并诊断强烈预测了 22 年评估时的 AN-限制型诊断。研究摄入时较高的体重指数（BMI）降低了与恢复相比 22 年后被诊断为 AN-暴食清除型的可能性。唯一增加 BN 诊断可能性的预测因素是在研究期间符合 BN 诊断标准的时间长度。
这些结果表明，暴食和清除行为的存在和持续是预后不良的指标，并且抑郁共病在 AN 中尤为有害。治疗提供者可能会特别关注这些问题，以努力在长期内积极影响康复。
