Do adolescents with eating disorder not otherwise specified or full‐syndrome bulimia nervosa differ in clinical severity, comorbidity, risk factors, treatment outcome or cost?

Abstract

EDNOS in adolescents is not trivial. It has milder eating disorder symptoms but more comorbidity than BN.

Update on course and outcome in eating disorders

“…Several studies have examined outcome among individuals with EDNOS that are characterized by bulimic symptoms and compared these individuals to those meeting full criteria for BN. 1,9,11,13 For shorter durations of follow-up (i.e., less than 5 years), remission rates for EDNOS appear to be considerably higher (67-69%) than those reported for BN (28-37%).…”

“…As with studies of AN, remission rates for follow-up studies of BN are lowest for those with the shortest duration of follow-up (27-28% at 1-year follow-up) 8,9 and increase as duration of follow-up increases (up to 70% or more by 10-year follow-up). 12,13 Recruitment source has a less apparent effect on outcome as results from a long-term follow-up study of an inpatient sample 12 are similar to results from studies of natural course in community-based samples.…”

“…1,9 Schmidt et al 9 reported a statistically significant difference in abstinence from both binge-eating and purging at 1-year follow-up between adolescents with baseline diagnoses of EDNOS vs. BN. However, this advantage appears to diminish with duration of follow-up.…”

“…Among recent studies of AN outcome, Eisler et al 3 reported no significant differences between adolescents treated with conjoint vs. separated family therapy. In an RCT of BN and related EDNOS in adolescents, Schmidt et al 9 reported no significant effect of treatment with guided self-help versus family therapy for changes in binge frequency or vomiting frequency over 1 year follow-up. Bailer et al 8 reported that guided self-help led to superior outcomes compared to CBT for BN among treatment completers but not in intent-to-treat analyses.…”

Academy for eating disorders position paper: Eating disorders are serious mental illnesses

“…78 Comorbidity profiles of EDNOS have been shown to be comparable to or exceed those of BN. 79,80 As with genetic/neurobiological alterations, substantial deficits in cognitive and emotional functioning are present in individuals with eating disorders. These deficits are similar to those observed in mood disorders 81 and anxiety disorders 82 and are themselves associated with their own set of genetic and biological risk factors.…”