Outcome and prognostic factors for adolescent female in-patients with anorexia nervosa: 9- to 4-year follow-up

BACKGROUND: Earlier studies have indicated poor long-term outcomes for patients with anorexia nervosa. AIMS: To study health and social outcomes of adolescent in-patients with anorexia nervosa in relation to prognostic factors. METHOD: A register study based on based on socio-economic and health data was conducted for a national cohort of female residents in Sweden born between 1968 and 1977, including 748 in-patients with anorexia nervosa. RESULTS: At follow-up 9-14 years after hospital admission, 8.7% of patients with anorexia nervosa had persistent psychiatric health problems demanding hospital care and 21.4% were dependent on society for their main income; the stratified relative risks were 5.8 (95% CI 4.7-7.6) and 2.6 (2.3-3.0) respectively, compared with the general female population. The mortality rate for patients with anorexia nervosa was 1.2% and the stratified risk ratio for maternity was 0.6 (95% CI 0.5-0.7). Long duration of hospital care and psychiatric comorbidity were predictors of persistent psychiatric problems and financial dependency on society. CONCLUSIONS: The outcome in this cohort of adolescent in-patients with anorexia nervosa was considerably better than that reported in previous studies.