Adolescent-onset anorexia nervosa: 18-year outcome.

Abstract

Background: The long-term outcome of anorexia nervosa is insufficiently researched. Aims: To study prospectively the long-term outcome and prognostic factors in a representative sample of people with teenage-onset anorexia nervosa. Method: Fifty-one people with anorexia nervosa, recruited by community screening and with a mean age at onset of 14 years were compared with 51 matched comparison individuals at a mean age of 32 years (18 years after disorder onset). All participants had been examined at ages 16 years, 21 years and 24 years. They were interviewed for Axis I psychiatric disorders and overall outcome (Morgan–Russell assessment schedule and the Global Assessment of Functioning). Results: There were no deaths. Twelve per cent ( n =6) had a persisting eating disorder, including three with anorexia nervosa. Thirty-nine per cent of the anorexia nervosa group met the criteria for at least one psychiatric disorder. The general outcome was poor in 12%. One in four did not have paid employment owing to psychiatric problems. Poor outcome was predicted by premorbid obsessive–compulsive personality disorder, age at onset of anorexia nervosa and autistic traits. Conclusions: The 18-year outcome of teenage-onset anorexia nervosa is favourable in respect of mortality and persisting eating disorder.