Factors associated with recovery from anorexia nervosa

• Published in: Journal of psychiatric research Vol. 47; no. 7; pp. 972 - 979
• Main Authors: Zerwas, Stephanie, Lund, Brian C, Von Holle, Ann, Thornton, Laura M, Berrettini, Wade H, Brandt, Harry, Crawford, Steven, Fichter, Manfred M, Halmi, Katherine A, Johnson, Craig, Kaplan, Allan S, La Via, Maria, Mitchell, James, Rotondo, Alessandro, Strober, Michael, Woodside, D. Blake, Kaye, Walter H, Bulik, Cynthia M
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-07-2013; Elsevier
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Anorexia nervosa; Anorexia Nervosa - diagnosis; Anorexia Nervosa - epidemiology; Anorexia Nervosa - physiopathology; Anorexia Nervosa - psychology; Biological and medical sciences; Comorbidity; Eating behavior disorders; Eating disorders; Female; Humans; Impulsivity; International Cooperation; Medical sciences; Medicin och hälsovetenskap; Mental Disorders - epidemiology; Middle Aged; Personality; Prognosis; Prognostic factors; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Recovery; Recovery of Function - physiology; Retrospective Studies; Survival Analysis; Time Factors; Trait anxiety; Young Adult; Personality; Anorexia nervosa; Comorbidity; Recovery; Prognostic factors; Eating disorders; Concomitant disease; Prognosis; Eating disorder
• ISSN: 0022-3956; 1879-1379; 1879-1379
• DOI: 10.1016/j.jpsychires.2013.02.011

Abstract Previous studies of prognostic factors of anorexia nervosa (AN) course and recovery have followed clinical populations after treatment discharge. This retrospective study examined the association between prognostic factors—eating disorder features, personality traits, and psychiatric comorbidity—and likelihood of recovery in a large sample of women with AN participating in a multi-site genetic study. The study included 680 women with AN. Recovery was defined as the offset of AN symptoms if the participant experienced at least one year without any eating disorder symptoms of low weight, dieting, binge eating, and inappropriate compensatory behaviors. Participants completed a structured interview about eating disorders features, psychiatric comorbidity, and self-report measures of personality. Survival analysis was applied to model time to recovery from AN. Cox regression models were used to fit associations between predictors and the probability of recovery. In the final model, likelihood of recovery was significantly predicted by the following prognostic factors: vomiting, impulsivity, and trait anxiety. Self-induced vomiting and greater trait anxiety were negative prognostic factors and predicted lower likelihood of recovery. Greater impulsivity was a positive prognostic factor and predicted greater likelihood of recovery. There was a significant interaction between impulsivity and time; the association between impulsivity and likelihood of recovery decreased as duration of AN increased. The anxiolytic function of some AN behaviors may impede recovery for individuals with greater trait anxiety.