A follow-up study of thirty hospitalized bulimics.

Abstract

Thirty normal-weight female bulimics were followed up 2-5 years following hospital admission using semistructured interviews and psychometric measures. Inasmuch as bulimia was only recently designated a distinct disorder, questions have emerged with regard to its clinical course and diagnostic validity. Results of this investigation suggest that bulimia displays a chronic but tractable course in that the majority of the patients continued to report bulimic behaviors at follow-up but the symptom intensity was greatly reduced from admission. The characterization of three bulimic outcome groups suggests that the outcome pattern of this disorder is heterogeneous, with some patients becoming symptom-free and others remaining severely afflicted. The durability of the symptoms and the failure of new psychiatric syndromes to emerge in the follow-up period is evidence that bulimia is a distinct diagnostic entity and not a variant of another underlying condition. The methodologic limitations of this study are addressed.

Treating Bulimia Nervosa With a Stratified-Care Approach

“…These patients often have a better prognosis than those who function poorly and whose disordered eating symptoms are of sufficient severity to merit hospitalization. 31 As expected, the control group, which was not treated in our program, had statistically significant lower scores regarding symptom withdrawal, as well as for sexuality and social adjustment scores. However, although most patients in this group did not receive multimodal treatment, many had spontaneous improvement in the measured variables.…”

“…28 Relapse rates between 30% and 50% have been reported for successfully treated patients after 6 months to 6 years of follow-up, and some data suggest that slow improvement continues as the period of follow-up extends to 10 to 15 years. [27][28][29][30][31] In a large study of the longterm course of patients with bulimia nervosa, 6 years after successful treatment in an intensive program, 30 outcomes of 60% of the patients were rated as good, 29% were of intermediate success, and 10% were poor, with 1% deceased. Kordy et al 25 also reported a 60% improvement in symptoms among bulimic patients at a 2.5-year follow-up, but only 18% achieved full remission and 16% were considered recovered.…”

Advances in Diagnosis and Treatment of Anorexia Nervosa and Bulimia Nervosa*

“…In one study, Swift and colleagues (72), reporting on a small sample of women with BN at least two years after discharge from hospital, found that 27% were asymptomatic, 40% had an intermediate outcome, and the remaining 33% had a poor outcome with "bingeing or purging on a daily basis." Weight fluctuations and dissatisfaction with their body persisted.…”

Outcome in bulimia nervosa

“…It is possible that the numerous studies that did not include information regarding crossover found no crossover to anorexia nervosa, as was specifically reported for two cohorts (3,14,20,21,44). From the research reviewed, it appears that the rate of crossover from bulimia nervosa to anorexia nervosa is much smaller than the crossover from anorexia nervosa to bulimia nervosa at follow-up (estimated range=10% to 50%) (46).…”