Abstract
BackgroundEating disorders are often characterised as disabling, chronic or relapsing conditions with high mortality rates. This study reports follow-up outcomes for patients seen at the Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED), whose end of treatment outcomes are reported in a separate paper.MethodsThree-hundred-and-fifty-seven former patients, who received evidence-based treatment for an eating disorder as a child or adolescent in MCCAED between 2009 and 2014 were eligible to participate. Current contact information was available for 290, of whom 149 (51.4%) consented to follow-up. Participants were sent links to online questionnaires, with additional demographic information extracted from medical records. Descriptive analyses of key socioeconomic and health outcomes were performed on data collected.ResultsMean length of follow-up was 6 years 11 months. Ten (6.7%) participants reported a current diagnosis of an eating disorder at follow-up. The great majority reported no (63.8%) or minimal (26.8%) interference from eating disorder difficulties. More than half (53.6%) reported other mental health diagnoses with most reporting no (33.8%) or minimal (50.7%) interference from those difficulties. One third (33.3%) had sought help for an eating disorder and around 20% received prolonged/intensive treatment during the follow-up period. Approximately 70% had sought treatment for other mental health difficulties (mostly anxiety or depression) and 35.4% had substantial treatment. At follow-up more than half (55.5%) reported doing generally well, and around two-thirds reported general satisfaction with their social well-being (65%). The majority (62.7%) had a good outcome on the Morgan Russell criteria, which was consistent with low self-reported ratings on EDE-Q, and low impact of eating disorder or mental health symptoms on work and social engagement. Most of the former patients who had day and/or inpatient treatment as a part of their comprehensive integrated care at MCCAED did well at follow-up.ConclusionsYoung people seen in specialist eating disorder services do relatively well after discharge at longer-term follow-up especially regarding eating disorders but less favourably regarding other mental health difficulties. Few reported a diagnosable eating disorder, and the great majority went on to perform similarly to their peers in educational and vocational achievements.
Highlights
Eating disorders are often characterised as disabling, chronic or relapsing conditions with high mortality rates
The study was designed in collaboration with former service users, to ensure that measures of recovery were relevant to people with lived experience
Very few (6.7%) reported having an eating disorder at follow-up, more than half (53.6%) reported other mental health difficulties during the follow up period
Summary
Eating disorders are often characterised as disabling, chronic or relapsing conditions with high mortality rates. Follow-up studies of adolescents treated for AN and related disorders with eating disorder focussed family therapy, the first line recommended treatment by the National Institute for Health and Care Excellence (NICE) [5] and other national guidelines [6] show that a significant proportion continue to experience eating disorder symptoms at 30-month [7], 4-year [8, 9] and 5-year [10] follow-up. Less is known about the outcomes following treatment for BN in adolescence, with one study reporting less than 50% abstinence rates from the core BN binge/purge symptoms at 12 months follow-up post treatment [11]. Recent studies at a population level [13] of a 6-year follow-up of 11–17 year olds indicate stability of eating disorder symptoms and associations with poor mental health outcomes
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