Recovery From Anorexia Nervosa and Bulimia Nervosa at 22-Year Follow-Up

Eddy, Kamryn T.; Tabri, Nassim; Thomas, Jennifer J.; Murray, Helen Burton; Keshaviah, Aparna; Hastings, Elizabeth; Edkins, Katherine; Krishna, Meera; Herzog, David B.; Keel, Pamela K.; Franko, Debra L.

doi:10.4088/jcp.15m10393

Cited by 348 publications

(310 citation statements)

References 31 publications

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“…The current sample of recAN women had an average AN duration of 3.7 years and is therefore relatively non-severe compared to other samples of AN individuals followed up after many years (Eddy et al, 2017).…”

Section: Strengths and Limitationsmentioning

confidence: 78%

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Visual scanning during emotion recognition in long‐term recovered anorexia nervosa: An eye‐tracking study

Dinkler

Dobrescu

Råstam

et al. 2019

Intl J Eating Disorders

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Objective: To examine Facial Emotion Recognition (FER) and visual scanning behavior (eye-tracking) during FER in women long-term recovered from teenage-onset anorexia nervosa (recAN) with and without autism spectrum disorder (±ASD) and age-matched comparison women (COMP), using a sensitive design with facial emotion expressions at varying intensities in order to approximate real social contexts.Method: Fifty-seven 38-47-year-old women (26 recAN of whom six with ASD, 31 COMP) participated in the study. They completed a non-verbal FER task, consisting of matching basic emotions at different levels of expression intensity with full emotional expressions. Accuracy, response time and visual scanning behavior were measured.Results: There were no differences between recAN-ASD and COMP in FER accuracy and visual scanning behavior during FER, including eye viewing and hyperscanning. In an exploratory analysis, recAN+ASD were more accurate than recAN-ASD in identifying expressions at low intensity, but not at medium or high expression intensity.Accuracy was not associated with the extent of attention to the eye region.Discussion: Our data indicate that women long-term recovered from adolescentonset AN do not have deficits in basic FER ability and visual scanning behavior during FER. However, the presence of comorbid ASD might affect face processing in recovered AN. Future studies investigating basic FER in acute and recovered AN and other conditions need to ensure that the stimuli used are sensitive enough to detect potential deficits. K E Y W O R D Sanorexia nervosa, autism spectrum disorder, emotion recognition, eye tracking, facial expression

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Section: Strengths and Limitationsmentioning

confidence: 78%

“…This could be because we followed up a population-and communitybased group and not a clinical group like Eddy et al (2017). Our results might therefore not generalize to a clinical sample, but are representative for individuals recovered from less-severe AN.…”

Section: Strengths and Limitationsmentioning

confidence: 92%

Visual scanning during emotion recognition in long‐term recovered anorexia nervosa: An eye‐tracking study

Dinkler

Dobrescu

Råstam

et al. 2019

Intl J Eating Disorders

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“…One interesting epidemiological study collected data on 71 BN patients from general practitioners. The longest follow-up was reported by Eddy et al (2017). Only a few studies reported on the outcome of BN after at least 10 years.…”

Section: Introductionmentioning

confidence: 99%

Long‐term outcome of inpatients with bulimia nervosa—Results from the Christina Barz Study

Quadflieg¹,

Fichter

2019

Intl J Eating Disorders

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Objective: To assess the long-term outcome and identify outcome predictors in a very large sample of inpatients treated for bulimia nervosa (BN).Method: Out of a total of 2,033 patients admitted consecutively to specialized treatment, 1,351 patients (mean age at treatment 25.94) were assessed for follow-up on average 11 (SD 6) years after admission. Also a very long-term (21 years) subsample (N = 147; mean age 25.92) was defined. Bivariate and logistic regression analyses identified predictors of poor outcome.Results: For more than 70% of the patients follow-up information could be gathered.Severity of eating disorder (ED) and other symptoms decreased over time but remained higher than in healthy controls, using published normative data. Remission rate was 38% after 11 years and 42% in the subsample after 21 years. Out of the total sample of N = 2,033 patients, 49 had died (2.4%). Persistent BN was found in 14.2% and the most frequent crossover was to ED not otherwise specified. Predictors of poor outcome were fewer follow-up years, higher drive for thinness, higher age at treatment, and less global functioning.Discussion: Based on clinical indicators, patients presented with a high level of ED and psychiatric symptomatology. With less than half of the patients remitted after 22 years, efforts are needed to improve treatment outcome. K E Y W O R D S

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“…Predominantly affecting women, the disease has a lifetime prevalence approaching 2.2% [2]. Importantly, the recovery rate is only approximately 50-60% and therefore this is a chronic disease for nearly half the women who are diagnosed [3, 4]. …”

Section: Introductionmentioning

confidence: 99%

The paradox of marrow adipose tissue in anorexia nervosa

Fazeli

Klibanski

2019

Bone

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Anorexia nervosa (AN) is a psychiatric disorder characterized by inappropriate nutrient intake resulting in low body weight. Multiple hormonal adaptations facilitate decreased energy expenditure in this state of caloric deprivation including non-thyroidal illness syndrome, growth hormone resistance, and hypogonadotropic hypogonadism. Although these hormonal adaptations confer a survival advantage during periods of negative energy balance, they contribute to the long-term medical complications associated with AN, the most common of which is significant bone loss and an increased risk of fracture. In recent years, marrow adipose tissue (MAT) has emerged as an important potential determinant of the low bone mass state characteristic of AN. Unlike subcutaneous and visceral adipose tissue depots which are low in AN, MAT levels are paradoxically elevated and are inversely associated with BMD. In this review, we discuss what is known about MAT in AN and the proposed hormonal determinants of this adipose tissue depot.

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Recovery From Anorexia Nervosa and Bulimia Nervosa at 22-Year Follow-Up

Cited by 348 publications

References 31 publications

Visual scanning during emotion recognition in long‐term recovered anorexia nervosa: An eye‐tracking study

Visual scanning during emotion recognition in long‐term recovered anorexia nervosa: An eye‐tracking study

Long‐term outcome of inpatients with bulimia nervosa—Results from the Christina Barz Study

The paradox of marrow adipose tissue in anorexia nervosa

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