Long‐term outcome of inpatients with bulimia nervosa—Results from the Christina Barz Study. Issue 7 (19th April 2019) - Quadflieg, Norbert
Abstract: 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.