Treatment of Anorexia Nervosa: The Importance of Disease Progression in the Prognosis.

Abstract

Anorexia nervosa is a severe, usually chronic, life-threatening disease of complex etiology characterized by foodrestriction, overestimation of the importance of body weight and image, intense fear of weight gain and distortion of body image.Anorexia nervosa is associated with high rates of mortality, suicide and decreased quality of life. Our aim is to present an anorexianervosa treatment program offered in a major university hospital in Portugal, and to determine the impact of illness duration beforeadmission on the outcome. Our hypothesis is that patients with greater disease longevity may have worse prognosis and pooreroutcome. The sample included data from case records of 169 patients seen consecutively and for the first time at CentroHospitalar São João, between 2010 and 2015. We performed a retrospective observational study which included data collected atadmission and from later follow-up years. From the initially selected patients, 14.8% reached total remission, 16% accomplished partial remission and 14.2% ended upwith exacerbation/stagnation of the disease. The dropout rate was of 55% throughout our study period. We found significant differenceson outcome rates between distinct illness duration groups (p = 0.007). There are several factors frequently associated with poor outcome for anorexia nervosa. The interpretation of outcomefindings was limited by the high rate of dropout and lack of consistent definition criteria. Our results support the idea that illness duration has an important role on the outcome and prognostic features of thesepatients.