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Bulimia nervosa: a 5-year follow-up study

Published online by Cambridge University Press:  09 July 2009

E. Johnson-Sabine*
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
D. Reiss
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
D. Dayson
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
*
1 Address for correspondence: Dr. E. Johnson-Sabine, Academic Department of Psychiatry, Royal Free Hospital, Pond Street, London NW3 2QG.

Synopsis

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.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1992

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References

REFERENCES

Abraham, S. F., Mira, M. & Llewellyn-Jones, D. (1983). Bulimia: a study of outcome. International Journal of Eating Disorders 2, 175180.3.0.CO;2-7>CrossRefGoogle Scholar
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd edn.) APA: Washington DC.Google Scholar
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised). APA: Washington DC.Google Scholar
Bulik, C. M. (1987). Drug and alcohol abuse by bulimic women and their families. American Journal of Psychiatry 144, 16041606.Google ScholarPubMed
Corney, R. H. & Clare, A. W. (1985). The construction, development and testing of a self-report questionnaire to identify social problems. Psychological Medicine 15, 637649.CrossRefGoogle ScholarPubMed
Fairburn, C. G. & Beglin, S. J. (1990). Studies of the epidemiology of bulimia nervosa. American Journal of Psychiatry 147, 401408.Google Scholar
Fairburn, C. G., Kirk, J., O'Connor, M., Anastasiades, P. & Cooper, P. J. (1987). Prognostic factors in bulimia nervosa. British Journal of Clinical Psychology 26, 223224.Google Scholar
Garner, D. M. & Garfinkel, P. E. (1979). The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychological Medicine 9, 273279CrossRefGoogle ScholarPubMed
Hamilton, M. (1959). A rating scale for anxiety. British Journal of Medical Psychology 32, 5055.CrossRefGoogle Scholar
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5662.Google Scholar
Hsu, G. L. K. & Holder, D. (1986). Bulimia nervosa: treatment and short-term outcome. Psychological Medicine 16, 6570.Google Scholar
Hsu, G. L. K. & Sobkiewicz, T. A. (1989). Bulimia nervosa: a four-to six-year follow-up study. Psychological Medicine 19, 10351038.CrossRefGoogle ScholarPubMed
Johnson-Sabine, E. C., Wood, K. H. & Wakeling, A. (1984). Mood changes in bulimia nervosa. British Journal of Psychiatry 145, 512516.CrossRefGoogle ScholarPubMed
Johnson-Sabine, E. C., Wood, K. H., Patton, G., Mann, A. & Wakeling, A. (1988). Abnormal eating attitudes in London schoolgirls – a prospective epidemiological study: factors associated with abnormal response on screening questionnaires. Psychological Medicine 18, 615622.Google Scholar
Lacey, J. H. (1983). Bulimia nervosa, binge eating, and psychogenic vomiting: a controlled treatment, study and long-term outcome. British Medical Journal 286, 16091613.CrossRefGoogle ScholarPubMed
Lacey, J. H. & Evans, C. D. H. (1986). The impulsivist: a multi-impulsive personality disorder. British Journal of Addiction 81, 641649.CrossRefGoogle ScholarPubMed
Lacey, J. H. & Moureli, E. (1986). Bulimic alcoholics: some features of a clinical sub-group. British Journal of Addiction 81, 389393.CrossRefGoogle ScholarPubMed
Russell, G. F. M. (1979). Bulimia nervosa: an ominous variant of anorexia nervosa. Psychological Medicine 9, 429448.Google Scholar
Sabine, E. Johnson-, Yonace, A., Farrington, A. J., Barratt, K. H. & Wakeling, A. (1983). Bulimia nervosa: a placebo controlled double-blind therapeutic trial of mianserin. British Journal of Clinical Pharmacology 29, 195S202S.Google Scholar
Swift, W. J., Ritholz, M., Kalin, N. H. & Kaslow, N. (1987). A follow-up study of thirty hospitalized bulimics. Psychosomatic Medicine 49, 4555.Google Scholar