Cited by 389Eating Disorders and BehaviorsNutrition, Health and Food BehaviorChild Nutrition and Feeding Issues

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Relapse in anorexia nervosa: a survival analysis

CARTER, J. C., BLACKMORE, E., SUTANDAR-PINNOCK, K., WOODSIDE, D. B.·2004·Psychological Medicine

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Abstract

Background. Knowledge about factors that predict relapse in anorexia nervosa (AN) is needed for the development of effective relapse prevention treatments and may also advance understanding of the psychopathology of AN. The aim of the present study was to examine the rate, timing and prediction of relapse in AN following weight restoration in a specialized in-patient treatment programme. Method. Fifty-one consecutive first-admission AN patients who were weight-restored following in-patient treatment participated in the study. Follow-up assessments were conducted a median of 15 months post-discharge. Relapse of AN was defined as a body mass index <17·5 for 3 consecutive months. Data were analysed using Kaplan–Meier survival analysis and Cox regression. Results. The overall rate of relapse was 35% and the mean survival time was 18 months. The highest risk period was from 6 to 17 months after discharge. Several significant predictors of relapse were identified: a history of suicide attempt; previous specialized treatment for an eating disorder; severity of obsessive–compulsive symptoms at presentation; excessive exercise immediately after discharge; and residual concern about shape and weight at discharge. Conclusions. There continues to be a significant risk of relapse among AN patients who remain well for the first year post-discharge. Several variables were shown to be associated with an elevated risk of relapse. These findings have implications for the development of initial treatments and relapse prevention strategies for AN.

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Authors: CARTER, J. C., BLACKMORE, E., SUTANDAR-PINNOCK, K., & WOODSIDE, D. B.
Affiliations: University of Toronto (CA)
ORCID: WOODSIDE, D. B.
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 2004-04-21
Volume: 34
Issue: 4
Pages: 671-679
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s0033291703001168
OpenAlex: W1995412283
Cited by: 389
References: 33
Citations by year: 2026: 11 · 2025: 17 · 2024: 19 · 2023: 15 · 2022: 29 · 2021: 16 · 2020: 25 · 2019: 15 · 2018: 35 · 2017: 18 · 2016: 27 · 2015: 17 · 2014: 27 · 2013: 28 · 2012: 18
FWCI: 8.39
Type: journal article
Language: en
Open access: closed
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
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: anorexia nervosa, relapse, recurrence prediction, weight restoration, in-patient treatment, relapse prevention, suicide attempts, obsessive-compulsive symptoms, excessive exercise, body image concern, eating disorder psychopathology
MeSH terms: Adaptation, Psychological, Adult, Anorexia Nervosa, Body Weight, Female, Follow-Up Studies, Humans, Patient Acceptance of Health Care, Recurrence, Risk Factors, Body Mass Index, Survival Analysis

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Relapse in anorexia nervosa: a survival analysis

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