Adolescent-onset anorexia nervosa: 18-year outcome.

BACKGROUND The long-term outcome of anorexia nervosa is insufficiently researched. AIMS To study prospectively the long-term outcome and prognostic factors in a representative sample of people with teenage-onset anorexia nervosa. METHOD Fifty-one people with anorexia nervosa, recruited by community screening and with a mean age at onset of 14 years were compared with 51 matched comparison individuals at a mean age of 32 years (18 years after disorder onset). All participants had been examined at ages 16 years, 21 years and 24 years. They were interviewed for Axis I psychiatric disorders and overall outcome (Morgan-Russell assessment schedule and the Global Assessment of Functioning). RESULTS There were no deaths. Twelve per cent (n=6) had a persisting eating disorder, including three with anorexia nervosa. Thirty-nine per cent of the anorexia nervosa group met the criteria for at least one psychiatric disorder. The general outcome was poor in 12%. One in four did not have paid employment owing to psychiatric problems. Poor outcome was predicted by premorbid obsessive-compulsive personality disorder, age at onset of anorexia nervosa and autistic traits. CONCLUSIONS The 18-year outcome of teenage-onset anorexia nervosa is favourable in respect of mortality and persisting eating disorder.