Psychological Medicine

Original Articles

Bulimia nervosa: a 5-year follow-up study

E. Johnson-Sabinea1 c1, D. Reissa1 and D. Daysona1

a1 Academic Department of Psychiatry, Royal Free Hospital, London


Fifty patients with bulimia nervosa were followed up for a minimum length of 5 years. Standardized interviews, observer-rated instruments and self-rated questionnaires were employed both at entry and at completion of the follow-up period. After tracing, the positive response rate was 72%; one patient had died. At the time of follow-up 31% of those traced had made a complete recovery and 25% still fulfilled diagnostic criteria for bulimia nervosa. Judged on behavioural symptoms 47·2% of responders had a ‘good’ outcome. Good outcome was associated with fewer social problems, higher social class, and a significant improvement in eating attitudes at follow-up. All outcome groups reported a reduction of interference by symptoms in other areas of life, and an improvement in mood state. No factors, including those described in previous studies, were identified which predicted outcome.


c1 Address for correspondence: Dr. E. Johnson-Sabine, Academic Department of Psychiatry, Royal Free Hospital, Pond Street, London NW3 2QG.