Stressful life events predict eating disorder relapse following remission: Six-year prospective outcomes
Article first published online: 29 MAR 2011
Copyright © 2011 Wiley Periodicals, Inc.
International Journal of Eating Disorders
Volume 45, Issue 2, pages 185–192, March 2012
How to Cite
Grilo, C. M., Pagano, M. E., Stout, R. L., Markowitz, J. C., Ansell, E. B., Pinto, A., Zanarini, M. C., Yen, S. and Skodol, A. E. (2012), Stressful life events predict eating disorder relapse following remission: Six-year prospective outcomes. Int. J. Eat. Disord., 45: 185–192. doi: 10.1002/eat.20909
- Issue published online: 7 FEB 2012
- Article first published online: 29 MAR 2011
- Manuscript Accepted: 25 NOV 2010
- MH. Grant Numbers: 50837, 50838, 50839, 50840, 50850, K24 DK070052, UL1 DE019586, K01 AA 015137, K23 MH80221, K23 MH80221 from NIH
- bulimia nervosa;
- eating disorder not otherwise specified;
- work stress
To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not-otherwise-specified (EDNOS) and test for the effects of stressful life events (SLE) on relapse after remission from these eating disorders.
117 female patients with BN (N = 35) or EDNOS (N = 82) were prospectively followed for 72 months using structured interviews performed at baseline, 6- and 12-months, and then yearly thereafter. ED were assessed with the structured clinical interview for DSM-IV, and monitored over time with the longitudinal interval follow-up evaluation. Personality disorders were assessed with the diagnostic interview for DSM-IV-personality-disorders, and monitored over time with the follow-along-version. The occurrence and specific timing of SLE were assessed with the life events assessment interview. Cox proportional-hazard-regression-analyses tested associations between time-varying levels of SLE and ED relapse, controlling for comorbid psychiatric disorders, ED duration, and time-varying personality-disorder status.
ED relapse probability was 43%; BN and EDNOS did not differ in time to relapse. Negative SLE significantly predicted ED relapse; elevated work and social stressors were significant predictors. Psychiatric comorbidity, ED duration, and time-varying personality-disorder status were not significant predictors.
Higher work and social stress represent significant warning signs for triggering relapse for women with remitted BN and EDNOS. © 2011 Wiley Periodicals, Inc. (Int J Eat Disord 2012)