Outcome of eating disorders in a primary care-based study.

Purpose: Most outcome studies of eating disorders are based on samples of patients that had entered specialized mental health care. This might be a group that does not represent all patients with an eating disorder and possibly shows a different course and outcome. Little is known about the outcome of newly diagnosed patients with an eating disorder in primary care. Method: We studied the course and outcome of eating disorders in a nationwide 3–7 year follow-up study of patients detected in primary care in two previous incidence studies (1985–1989 & 1995–1999). The method of data collection was identical for both periods. The research team assessed the outcome (good, intermediate and poor) at followup based on the information provided by the GPs by questionnaire. In the assessment BMI, menstrual status, binge eating, purging behavior (self-induced vomiting & laxative use), the opinion of the GP about recovery and the overall level of functioning were considered. Results: Response rates were 67% for anorexia nervosa restrictive subtype (ANR), 80% for anorexia nervosa binge/purge subtype (ANBP) and 69% for bulimia nervosa (BN).We assessed the representativeness of the follow-up sample. Good outcome was found for 55% ANR, 57% ANBP and 61% for BN. Poor outcome was found for 21% ANR, 23% ANBP and 6% of BN. The BN group had the shortest median time to recovery (2.8 yrs) and this differed significantly with the ANBP group (4.4 yrs) (Logrank = 4.6; p = .03). Age at detection was a predictor for both eating disorders.A younger age at detection predicted a favorable outcome. Conclusions: After a mean of 4.8 years follow-up more than half the patients of an eating disorder cohort detected in primary care could be considered recovered.ANBP showed the most extended median survival time. Early detection in primary care is of major importance. (aut. ref.