Evaluation of treatment and intermediate and long-term outcome of adolescent eating disorders

Background. A cohort of 60 adolescent eating-disordered patients that was consecutively admitted between 1979 and 1988 to a child and adolescent psychiatric university department in Berlin, Germany was followed up at a mean of 5.0 years and for a second time at a mean of 11.5 years. Methods. Each patient was personally interviewed and findings dealing with eating disorder symptoms and psychosocial functioning were rated on four-point scales. In addition, the duration of both in-patient and out-patient treatment and the Body Mass Index (BMI) were recorded. Results. Patients were in treatment for a mean of 33% of the initial 5-year follow-up period, but this has dropped to a mean of 17% of the entire 11-year follow-up period. No predictors of treatment duration were found. The mortality rate was 8.3% at the second follow-up. The distribution of abnormal BMIs (< 17.5) reflected a trend of improvement with increasing duration of follow-up. In comparison to the 5-year follow-up, fewer patients suffered from symptoms of the full clinical picture of an eating disorder at the Ii-year follow-up. Among the surviving patients 80% recovered during the long-term course. There were few specific predictors of three different outcome criteria. Conclusion. This outcome study of adolescent eating disorders provides further evidence that the long-term course of the disorders in terms of the eating pathology is better than can be expected after a few years. Very little can be said with regard to individual prognosis.