Factors associated with recovery from anorexia nervosa: A population-based study
Article first published online: 30 OCT 2013
Copyright © 2013 Wiley Periodicals, Inc.
International Journal of Eating Disorders
Volume 47, Issue 2, pages 117–123, March 2014
How to Cite
Keski-Rahkonen, A., Raevuori, A., Bulik, C. M., Hoek, H. W., Rissanen, A. and Kaprio, J. (2014), Factors associated with recovery from anorexia nervosa: A population-based study. Int. J. Eat. Disord., 47: 117–123. doi: 10.1002/eat.22168
- Issue published online: 3 FEB 2014
- Article first published online: 30 OCT 2013
- Manuscript Accepted: 1 JUL 2013
- Manuscript Revised: 27 JUN 2013
- anorexia nervosa;
- twin study;
To examine factors associated with the outcome of anorexia nervosa among women from the general population.
Women (N = 2,881) from the 1975–1979 birth cohorts of Finnish twins were screened for lifetime DSM-IV anorexia nervosa (N = 55 cases) using questionnaires and the SCID interview. Potential factors associated with the likelihood of recovery were addressed in the same assessment. Recovery was defined as restoration of weight, menstruation, and the absence of bingeing and purging for at least one year prior to assessment. Using two-tailed t tests and Pearson's chi-square tests, we contrasted recovered (N = 39) and unrecovered (N = 16) women. We then used logistic regression adjusted for duration of illness and Cox proportional hazard models to account for the variable lengths of illness on prognostic factors.
Unrecovered women were more likely to suffer from depressive symptoms prior to eating disorder onset (18.8% vs. 2.6%, p = 0.04), remain unemployed (18.8% vs. 2.6%, p = 0.04), report dissatisfaction with their current partner/spouse (p = 0.02), and report high perfectionism (p = 0.05) than were recovered women. When duration of illness was accounted for in the analyses, premorbid depression was the sole factor significantly associated with decreased likelihood of recovery (hazard ratio 0.17, 95% confidence interval: 0.03–0.89).
Predicting the course of anorexia remains fraught with difficulty, but premorbid depressive symptoms are associated with poor outcome of anorexia nervosa in the general population. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:117–123)