Longitudinal comparison of anorexia nervosa subtypes

Eddy, Kamryn T.; Keel, Pamela K.; Dorer, David J.; Delinsky, Sherrie S.; Franko, Debra L.; Herzog, David B.

doi:10.1002/eat.10016

Cited by 214 publications

(190 citation statements)

References 27 publications

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“…Although research indicates that the overarching diagnosis of ''eating disorder'' is relatively stable, 3 several studies suggest that there is considerable longitudinal instability of the specific eating disorder diagnoses of AN, BN, and EDNOS in treatment samples, resulting from recovery, relapse, and crossover between and within the eating disorder diagnoses. 3,[4][5][6] The recovery rates for AN and BN were moderate to high at each of the follow-up assessments in Fichter and Quadflieg study, which is similar to the rates reported by Ben-Tovim et al, 7 who found that at 5-year follow-up, 56% of patients with AN, 74% of patients with BN, and 78% of patients with EDNOS no longer met criteria for any eating disorder diagnosis.…”

Section: Long-term Stability Of Eating Disorder Diagnoses (Fichter Andsupporting

confidence: 74%

“…Another study indicated that 40% of the patients with BN recovered over a 2-year follow-up 8 and 74% had recovered by 5-year follow-up. 6 Eddy et al 4 found that 46% of patients with restricting AN and 39% of patients with binge/ purge AN achieved recovery over a period of 8 years. Moreover, another prospective study of a treatment sample found that the average duration of AN was 10 years.…”

Section: Long-term Stability Of Eating Disorder Diagnoses (Fichter Andmentioning

confidence: 99%

“…16 Several prospective studies of clinical samples found that many participants with AN develop bulimic symptoms within the first 5 years of their disorder. 4,17 Fichter and Quadflieg found that 10% of those with AN developed BN by 2-12 year follow-up. Furthermore, consistent with other prospective studies (e.g., Refs.…”

Section: Long-term Stability Of Eating Disorder Diagnoses (Fichter Andmentioning

confidence: 99%

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Stability of eating disorder diagnoses: A commentary

Stice

Spoor

2007

Int. J. Eat. Disord.

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Eat ing disorders, including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), are one of the most prevalent psychiatric problems for girls and young women, result in subjective distress and functional impairment, and increase risk for future onset of obesity, depression, suicide attempts, anxiety disorders, substance abuse, and health problems. 1,2 Although these eating disorders are clearly associated with functional impairment, less is known about the course of these eating disorder diagnoses over time. The purpose of this commentary is to discuss the findings of two articles on the longitudinal course of eating disorder diagnoses that appear in this special issue to discuss implications for nosology, and to offer suggestions regarding future research in this area.Long-term Stability of Eating Disorder Diagnoses (Fichter, & Norbert) This manuscript reports data on the stability of eating disorders over a 12-year period in a large treatment sample (N 5 311). Assessments were conducted at the beginning of therapy and at 2-year, 6-year, and 12-year follow-ups. The 12-year stability rate was 41.4% for AN, 34.4% for BN, 3.0% for BED, and 3.2% for other eating disorder not otherwise specified diagnoses (EDNOS). Results suggest moderate longitudinal instability of AN and BN, and pronounced longitudinal intability of BED and other EDNOS conditions. This instability was due to recovery, relapse, and diagnostic crossover. Most crossovers occurred from AN to BN and from BED to BN. Long-term outcome for BN and BED was encouraging, with both showing high recovery rates. The long-term outcome for AN was worse relative to BN and BED. Furthermore, the longitudinal course of BN and BED seemed to be nearly identical with similar percentages of remission and relapse. Relapse rates were low in this treatment sample.Before discussing the implications of these findings for nosology and future research directions, it is important to compare the findings from this study with other studies that have been previously published. Although research indicates that the overarching diagnosis of ''eating disorder'' is relatively stable, 3 several studies suggest that there is considerable longitudinal instability of the specific eating disorder diagnoses of AN, BN, and EDNOS in treatment samples, resulting from recovery, relapse, and crossover between and within the eating disorder diagnoses. 3,4-6 The recovery rates for AN and BN were moderate to high at each of the follow-up assessments in Fichter and Quadflieg study, which is similar to the rates reported by 7 who found that at 5-year follow-up, 56% of patients with AN, 74% of patients with BN, and 78% of patients with EDNOS no longer met criteria for any eating disorder diagnosis.Recovery rates of other treatment studies, however, are somewhat lower. For example, Fichter and Quadflieg reported a remission rate of 43.8% in AN and 56.8% in BN over a 2-year period; these recovery rates increased to about 60% for AN and about 70% for BN over a 6-12-year period....

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Section: Long-term Stability Of Eating Disorder Diagnoses (Fichter Andsupporting

confidence: 74%

Section: Long-term Stability Of Eating Disorder Diagnoses (Fichter Andmentioning

confidence: 99%

Section: Long-term Stability Of Eating Disorder Diagnoses (Fichter Andmentioning

confidence: 99%

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Stability of eating disorder diagnoses: A commentary

Stice

Spoor

2007

Int. J. Eat. Disord.

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“…7 However, recent studies, including prospective longitudinal studies, have failed to find significant evidence of differences between the binge purge and restricting subtypes of AN in comorbid psychopathology, recovery, relapse, or mortality rates. 8 In addition, most individuals with restricting AN are likely to report some binge-purge behaviors over time. 8 This evidence may suggest that AN binge-purge subtype represents a more severe or chronologically advanced form of AN, rather than a distinct diagnostic subtype.…”

Section: Anorexia Nervosamentioning

confidence: 99%

Classification of eating disorders: Toward DSM-V

Wilfley

Bishop

Wilson

et al. 2007

Int. J. Eat. Disord.

150

117

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Objective: A goal of the DSM-IV revision is to increase clinical and research utility by improving diagnostic validity through reliance on empirical evidence. Currently defined eating disorder (ED) categories have limited validity and require refinement based on data. Method:The available scientific evidence is considered in evaluating the current ED nosology.Results: Specific recommendations include modifying ED classification by retaining categories but adding a dimensional component; removing the amenorrhea criterion for anorexia nervosa (AN); removing the subtypes for AN and bulimia nervosa (BN); making binge eating disorder (BED) an official diagnosis; and unifying the frequency and duration cut-points for BN and BED to once per week for 3 months. Priority research areas should include epidemiologic studies of full-range ED symptomatology and should focus on empirical validation for individual criterion.Conclusion: There are significant issues to address in revising ED nosology as we move toward a more valid and useful DSM-V. V V C 2007 by Wiley Periodicals, Inc.

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“…Between 8% and 62% of individuals with an initial diagnosis of AN develop bulimic symptoms at some point during the course of their illness, [29][30][31][32][33][34][35][36][37] with the majority of crossovers occurring within the first 5 years. 29,30,32,37 Understanding Risk Factors for Anorexia Nervosa AN afflicts fewer than 1% of the population.…”

Section: Pubertal Developmentmentioning

confidence: 99%