Short‐term follow‐up of severe bulimia nervosa after inpatient treatment

Abstract

AbstractObjective:There are few follow‐up studies on outcome for treatment‐resistant bulimics with comorbid personality disorders. Inpatient treatment may be one option for patients who have not responded to outpatient therapy. The aim of this prospective study was to report on the 1‐year follow‐up of long‐term severe bulimic patients treated in an inpatient eating disorder unit.Method:Fifty‐four patients were treated in a 4‐month specialized group treatment programme for bulimia nervosa. Patients were assessed using the Eating Disorder Examination interview (EDE), the Eating Disorder Inventory (EDI) and the Symptom Check List (SCL‐90‐R) at pre‐treatment, post‐treatment and at 1 year after the start of treatment. Fifty patients with a mean age of 31 years were available for the follow‐up assessment. On admission 72 per cent of the patients had bulimia nervosa, 26 per cent had unspecified eating disorder (EDNOS) and 2 per cent had the bulimic subtype of anorexia nervosa.Results:Twenty‐two (44 per cent) patients had good outcome at follow‐up (i.e. reduction of binges and/or purging by more than 75 per cent). Fourteen (28 per cent) had intermediate outcome (i.e. 25–74 per cent reduction of binges and/or purging) and 14 (28 per cent) had poor outcome (i.e. less than 25 per cent reduction in binging and/or purging or a symptom increase). There were significant reductions in most EDE, EDI and SCL‐90‐R subscale scores from pre‐treatment to follow‐up. The improvement on all of these subscales occurred during inpatient treatment and there were no significant changes from post‐treatment to follow‐up.Conclusion:Bulimic symptoms and general psychiatric symptoms were substantially reduced during the 4‐month inpatient treatment and these improvements were sustained at the follow‐up. Inpatient treatment may thus be an option for treatment‐resistant bulimia nervosa. Copyright © 2003 John Wiley & Sons, Ltd and Eating Disorders Association.