Prognosis in Anorexia Nervosa

Abstract

Prognosis in anorexia nervosa is usually expressed in terms of mortality rate and duration of illness. The clinical picture has infrequently been analyzed statistically for features presaging good or poor prognosis. The use of inconsistent criteria for the diagnosis of the disease has made it difficult to compare studies. Using the rigorous criteria of Feighner and associates, we found, in records of patients with this illness seen at the University of Iowa General and Psychiatric Hospitals, 42 that had sufficient follow-up information for analysis of the course of the disease. Demographic and clinical features were evaluated in two prognostically extreme groups (a total of 36 patients): those who recovered and had no relapses and those who did not recover. Onset of anorexia nervosa at an early age was significantly correlated with good prognosis, as was employment in professional and skilled occupations. Factors significantly associated with poor prognosis included vomiting, laxative abuse, psychosomatic complaints, and moderate to severe depressive and obsessive-compulsive manifestations.