Defining Recovery for Anorexia and Bulimia Nervosa: A 25-Year Outcome Study

厌食症和神经性贪食症康复的定义：一项 25 年结果研究

• 批准号: 8267009
• 负责人: Kamryn T Eddy
• 金额: $ 8.85万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8267009
• 关键词: Age; Alcohol abuse; Anorexia; Anorexia Nervosa; Behavioral Symptoms; Bulimia; Cessation of life; Chronic; Chronic Disease; Clinical; Comorbidity; Complex; Coupled; DSM-IV; Data; Data Set; Diagnostic; Eating Disorders; Emotional; Evaluation; Funding; Future; General Hospitals; Intake; Interview; Investigation; Life; Longitudinal Studies; Massachusetts; Medical; Mental Depression; Mental disorders; Morbidity - disease rate; National Institute of Mental Health; Neurobehavioral Manifestations; Outcome; Outcome Study; Participant; Patients; Phase; Positioning Attribute; Quality of life; Questionnaires; Recovery; Relapse; Research Personnel; Residual state; Resources; Risk; Sampling; Sampling Studies; Series; Severities; Severity of illness; Study Subject; Symptoms; Time; Weight; Woman; abstracting; base; cohort; design; experience; follow-up; indexing; meetings; mortality; premature; prospective; psychosocial; purge

DESCRIPTION (provided by applicant): Project Summary/Abstract Anorexia nervosa (AN) and bulimia nervosa (BN) are chronic and severe psychiatric illnesses associated with complex physical and emotional sequelae. Long-term studies of eating disorders are few in number and comprehensive understanding of the outcome of these illnesses has been challenged by a lack of an empirically-based definition of recovery. The current application proposes a one-time follow-up investigation of the surviving participants of the Massachusetts General Hospital Longitudinal Study of Anorexia and Bulimia Nervosa 25 years after initial funding for the project by NIMH began in 1987. This study of 246 treatment-seeking women, which included 51 women with AN-restricting subtype, 85 with AN-binge/purge subtype, and 110 with BN, is the only long-term, prospective, naturalistic study of its kind, making it an invaluable resource for promoting our understanding of the natural course of eating disorders. The cohort was interviewed at frequent intervals until 2000 for approximately 10 years of follow-up (median = 9 years, maximum = 12 years). The attrition rate at 10 years of follow-up was 7%. Annual contact has been maintained with the cohort. To date, we have confirmed participation in the proposed follow-up with 155 (67%) of our potentially 230 living participants and we continue our efforts to include an additional 44 subjects (only 31 subjects declined participation). This application proposes to establish an empirically-based definition of long-term eating disorder recovery by examining the predictive validity (comparing the first 10 years of follow-up to year 25) of a series of definitions of recovery that differ on thresholds of symptom severity and duration. The Eating Disorder Longitudinal Interval Follow-up Evaluation (the same interview administered in the initial phase of the study) will be used to gather data on eating disorder symptomatology, comorbid psychiatric disorders, and psychosocial functioning. Cross-sectional validity of recovery definitions will be examined using clinically meaningful indices such as quality of life. Finally, this study will document long-term outcome of eating disorders, including mortality rates, as well as the demographic and clinical predictors of 25-year outcome. The proposed study is uniquely positioned to examine these questions due to the availability of both a detailed dataset documenting the course of eating disorders over 10 years of follow-up as well as a high percentage of participants willing to be interviewed at the 25 year follow-up. Findings from this study will create a framework for the evaluation of current treatment efforts, assist in the design of future treatment studies, inform researchers conducting outcome studies, and provide clinicians, researchers, and patients with important clinical information about the outcome of eating disorders.

描述（由申请人提供）：神经性神经（AN）和神经性贪食症（BN）的项目摘要/摘要厌食症（BN）是慢性和严重的精神病，与复杂的身体和情感后遗症有关。对饮食失调的长期研究数量很少，并且由于缺乏基于经验的恢复定义，对这些疾病结果的全面了解受到了挑战。 The current application proposes a one-time follow-up investigation of the surviving participants of the Massachusetts General Hospital Longitudinal Study of Anorexia and Bulimia Nervosa 25 years after initial funding for the project by NIMH began in 1987. This study of 246 treatment-seeking women, which included 51 women with AN-restricting subtype, 85 with AN-binge/purge subtype, and 110 with BN, is the only long-term,对同类的前瞻性，自然主义的研究，使其成为促进我们对自然饮食失调过程的理解的宝贵资源。直到2000年的随访10年（中位数= 9年，最大= 12年），才经常访问该队列。随访10年时的损耗率为7％。与队列保持了年度联系。迄今为止，我们已经确认参与了拟议的后续行动，其中155名（67％）可能有230名活着的参与者，我们继续努力增加44名受试者（只有31名受试者拒绝参与）。该应用建议通过检查一系列恢复定义的预测有效性（将后续的10年与随访的前10年进行比较），以建立基于经验的长期饮食失调恢复的定义，这些定义在症状严重程度和持续时间的阈值方面有所不同。饮食失调纵向间隔随访评估（在研究的初始阶段进行的相同访谈）将用于收集有关饮食失调症状，合并症的精神疾病和社会心理功能的数据。恢复定义的横截面有效性将使用临床上有意义的指数（例如生活质量）进行检查。最后，这项研究将记录饮食失调的长期结局，包括死亡率，以及25年结果的人口统计学和临床​​预测指标。拟议的研究是独特的，可以研究这些问题，这是由于既有详细的数据集的可用性记录了10年的随访过程中的饮食失调过程，又有很高比例的参与者愿意在25年的随访中接受采访。这项研究的结果将为评估当前的治疗工作，帮助设计未来的治疗研究，为进行结果研究的研究人员提供信息，并为临床医生，研究人员和患者提供有关饮食失调结果的重要临床信息的框架。