A follow-up study of 33 subdiagnostic eating disordered women

Abstract

Thirty‐three female subjects with subdiagnostic DSM‐III‐R anorexia nervosa (SAN) and/or subdiagnostic bulimia nervosa (SBN) were reinterviewed 24 to 52 months (mean 41 months) after seeking treatment for an eating disorder. Subjects were administered a semi structured interview by telephone and assessed for level of functioning, eating disorder symptoms, course of illness, and treatment sought. During the course of the follow‐up, 15 (46%) subjects went on to meet full DSM‐III‐R criteria for AN and/or BN. At follow‐up, 4 (12%) met full DSM‐III‐R criteria for AN and/or BN, 22 (67%) were subdiagnostic, and 6 (18%) had recovered. The high percentage of subdiagnostic women that eventually develop full DSM‐III‐R criteria for AN and/or BN and the low rates of recovery at 2 to 4 years suggest that the current diagnostic criteria may be too restrictive. © 1993 by John Wiley & Sons, Inc.

The spectrum of eating disturbances

“…For example, in several studies 2625% of pathological dieters had progressed to a partial or full syndrome ED within 1 to 2 years after the initial evaluation (King, 1989(King, , 1991Patton et al, 1990;Schleimer, 1984). In other studies, a progression to full syndrome EDs was reported in 14% (Kmg, 1991), 33% (Yager et al, 1987), 37.5% (Striegel- Moore et al, 1989), and 46% (Herzog et al, 1993) of those who had originally been classified as having partial syndrome EDs.…”

“…In several 1-to 4-year studies, 3045% of those with partial syndrome had progressed to full syndrome EDs by the end of the study (Herzog et al, 1993;Striegel-Moore, Silberstein, Frensch, & Rodin, 1989;Yager, Landsverk, & Edelstein, 1987). Brooks-Gunn (1989,1992) are in the process of conducting a long-term study of 193 women who were first evaluated during middle school.…”

Epidemiology and Natural Course of Eating Disorders in Young Women From Adolescence to Young Adulthood

“…Studies that have compared full-syndrome (FS-ED) with PS-ED cases have found few differences on clinical and psychosocial characteristics (Kendler et al, 1991). Moreover, in a small case series of patients requesting treatment who were followed over time, about half of women with PS-ED were found to ultimately develop a full-syndrome disorder (Herzog et al, 1993). Thus, the second goal of this study is to examine the clinical characteristics and natural course of PS-ED in an adolescent community sample.…”

Assessment of the impact of eating disorders on quality of life using the disease-specific, Health-Related Quality of Life for Eating Disorders (HeRQoLED) questionnaire

“…Generally, the EDNOS are, a priori, less serious than anorexia or bulimia nervosa, as an important percentage of them, are mitigated or attenuated forms of these last two conditions. EDNOS cover non-specific syndromes, they are conceptually problematic to define and they form a heterogeneous group of diagnoses (e.g., including binging disorder), making it difficult to give a prognostic judgement about such conditions and, therefore, being common a variable evolution [25].…”