Long-term outcome in anorexia nervosa in the community

• Published in: The International journal of eating disorders 2015-11, Vol.48 (7), p.851-859
• Main Authors: Mustelin, Linda, Raevuori, Anu, Bulik, Cynthia M., Rissanen, Aila, Hoek, Hans W., Kaprio, Jaakko, Keski-Rahkonen, Anna
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anorexia; anorexia nervosa; Anorexia Nervosa - diagnosis; Body mass index; Child; Cohort Studies; Demographics; Diagnostic and Statistical Manual of Mental Disorders; Eating disorders; epidemiology; Female; Humans; Longitudinal Studies; Medicin och hälsovetenskap; Mortality; outcome; Prognosis; Treatment Outcome; twin study; Twins; Women; Young Adult
• ISSN: 0276-3478; 1098-108X; 1098-108X
• DOI: 10.1002/eat.22415

ABSTRACT Objective Few studies have assessed outcomes of anorexia nervosa (AN) outside clinical settings. We aimed to assess mortality, recovery, and socio‐demographic outcomes of AN in a community sample. Method Women in the nationwide FinnTwin16 cohort (born 1975–1979) were followed for 10 years after baseline diagnostic assessment (mean age at follow‐up 34 years, N = 2188). We compared women with lifetime DSM‐IV AN (N = 40) with unaffected women from the same cohort. Results None of the women with AN had died and 88% were weight‐recovered (BMI ≥ 18.5 kg/m2), but their mean BMI (22.0 kg/m2) was lower than among unaffected women (24.0 kg/m2, p = 0.008). University degrees (38 vs. 29%, p = 0.26), sickness absence during the past year (median 5 vs. 3 days, p = 0.21), or unemployment or disability pension (5 vs. 4%, p = 0.62) did not significantly differ between AN probands and their unaffected peers. More women with AN were still studying (15 vs. 4%, p = 0.003), and half of them had children, as compared to 66% of unaffected women (p = 0.05). Discussion The long‐term prognosis of AN in the community appears promising. Weight‐restoration is common and socio‐demographic outcomes are generally favorable. However, women with a history of AN may be less likely to have children. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:851–859).