Family functioning and life events in the outcome of adolescent anorexia nervosa

BACKGROUND: This study investigates the outcome of anorexia nervosa in adolescents in relation to precipitating life events and changes in family functioning over time. METHOD: Thirty-five adolescents with anorexia nervosa and their mothers were administered measures of life events and family functioning at initial assessment and 1 and 2 year follow-up, when outcome was also assessed. RESULTS: Fifty-five per cent of patients had a good outcome. Patients from initially well-functioning families or those with precipitating life events improved more in the first year, than those with dysfunctional families or without events. Subjects perceived a deterioration in family functioning at 1 year follow-up but an improvement at 2 years. Mothers reported no changes. CONCLUSIONS: Approximately half of a series of early onset cases of anorexia nervosa can be expected to recover by 2 years. Healthy family functioning and presence of a precipitating life event predict good short-term outcome. The relationships between subjects' perceptions of family functioning and their recovery from anorexia nervosa is discussed.