The impact of duration of illness on treatment nonresponse and drop-out: Exploring the relevance of enduring eating disorder concept
Open accessAbstract
OBJECTIVE: There are no generally accepted definitions or markers of treatment nonresponse in eating disorders (EDs). The aim of this paper was to examine how the duration of illness and other potential prognostic markers impacted on nonresponse and drop-out from treatment across different EDs subtypes. METHODS: A total sample of 1199 consecutively treated patients with EDs, according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria, participated in this study. Kaplan-Meier curves were calculated for each ED diagnosis in which the probability of recovery was plotted against the duration of illness. RESULTS: Full remission was more likely for people with binge eating disorder (BED; 47.4%) and anorexia nervosa (AN; 43.9%) compared to bulimia nervosa (BN; 25.2%) and other specified feeding and EDs (OSFED; 23.2%). The cut-off points for the duration of the illness related with high likelihoods of poor response was 6-8 years among OSFED, 12-14 years among AN and BN and 20-21 years among BED. Other variables predicting nonresponse included dysfunctional personality traits. CONCLUSIONS: Nonresponse to treatment is associated with duration of illness which is in turn associated with poor response to previous treatment. However, there was no evidence for staging the illness using specific duration of illness criteria. Nevertheless, the shorter temporal trajectory for OSFED suggests that early interventions may be of importance for this group.
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- Authors
- Fernández‐Aranda, F., Treasure, J., Paslakis, G., Agüera, Z., Giménez, M., Granero, R., Sánchez, I., Serrano‐Troncoso, E., Gorwood, P., Herpertz‐Dahlmann, B., Bonin, E., Monteleone, P., & Jiménez‐Murcia, S.
- Affiliations
- Instituto de Salud Carlos III (ES)
- King's College London (GB)
- Ruhr University Bochum (DE)
- Department of Psychiatry Bellvitge University Hospital‐IDIBELL Barcelona Spain
- Universitat Autònoma de Barcelona (ES)
- Institut de Recerca Sant Joan de Déu (ES)
- Inserm (FR)
- RWTH Aachen University (DE)
- London School of Economics and Political Science (GB)
- University of Salerno (IT)
- Corresponding author
- Fernández‐Aranda, Fernando
- ORCID
- Venue
- European Eating Disorders Review
- Publisher
- Wiley
- Published
- 2021-02-18
- Volume
- 29
- Issue
- 3
- Pages
- 499-513
- ISSN
- 1072-4133 (ISSN-L)
- 1099-0968
- OpenAlex
- W3131602955
- Cited by
- 99
- References
- 60
- Citations by year
- 2026: 10 · 2025: 20 · 2024: 32 · 2023: 19 · 2022: 10 · 2021: 8
- FWCI
- 11.76
- Type
- journal article
- Language
- en
- Open access
- green
- ddd.uab.cat
- Licence
- public-domain
- onlinelibrary.wiley.com/termsAndConditions#vor (vor)
- Locations
- European Eating Disorders Review (publishedVersion)
- PubMed (publishedVersion)
- London School of Economics and Political Science Theses Online (London School of Economics and Political Science) (acceptedVersion)
- Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, public-domain)
- Research Portal (King's College London) (submittedVersion)
- RWTH Publications (RWTH Aachen) (submittedVersion)
- Funders
- Instituto de Salud Carlos III (PI14/00290, PI17/01167)
- Generalitat de Catalunya (SLT006/17/00246)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- eating disorders, disease duration, treatment non-response, treatment discontinuation, binge eating disorder, anorexia nervosa, bulimia nervosa, other specified feeding or eating disorder, remission, prognostic factors, dysfunctional personality traits, early intervention
- MeSH terms
- Anorexia Nervosa, Feeding and Eating Disorders, Humans, Diagnostic and Statistical Manual of Mental Disorders, Bulimia Nervosa, Binge-Eating Disorder
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