Management and outcome in anorexia nervosa. A standardized prognostic study.
The outcome of 78 patients with anorexia nervosa treated in a special clinic is described, using a standardized follow-up technique. The findings are compared with two previous studies which utilized an identical evaluation procedure. Certain predictors of poor outcome already identified by previous studies (long duration of illness before referral, previous personality problems, difficulties in relationship between family and patient) are confirmed. The findings suggest that early intervention may be an important component of effective treatment. The possible advantages of long term continuity of outpatient care are also discussed and the need for careful scrutiny of criteria for hospital admission emphasized. It is concluded that chronic morbidity due to anorexia nervosa represents an important topic for further research. There is need for further identification of factors associated with chronicity, some of which may be secondary repercussions of the illness itself, and prospective evaluation of treatment programmes which focus on predictors of poor outcome.