Long-term follow up of hospitalized pediatric anorexia nervosa restricting type.

Background Information on long-term follow-up of childhood-onset anorexia nervosa is scarce. This study aimed to show long-term (>10 years) course, outcome and prognostic factors for hospitalized childhood-onset anorexia nervosa-restricting type (ANR). Methods Forty-one ANR girls admitted to a single regional center participated. Median age at first admission was 13.3 (range: 8.6-15.6) years. The longitudinal clinical course was retrospectively determined for a median follow-up period of 17.1 (range: 10.4–21.1) years. We analyzed physical, psychological, and social variables to predict achieving partial remission (PR) and full remission (FR). Results The completion rate of follow-up in excess of 10 years was high at 97%. At final evaluation (N=38), the prognoses were distributed as 27 FR patients (71%), 6 PR patients (16%), and 5 non-remission patients (13%). The cumulative ratio of PR and FR increased during the first 5-6 years, and gradually reached a plateau at around 10 years. More than 10 years after the onset, 1 patient eventually achieved FR, and 1 patient died. Seven patients were rehospitalized and 2 died of suicide during the entire follow-up. Multivariate analysis indicated that rating scores related to family disorders/problems were significant predictors for PR and FR. Conclusions This study included hospitalized ANR children aged under 15 years, the youngest cohort ever reported. Long-term prognosis is generally favorable; however, the mortality rate was 5%. Our findings suggest that careful long-term follow-up over 10 years is needed to evaluate outcome of childhood-onset ANR and that family therapy should be focused on high-risk patients with family disorders/problems. This article is protected by copyright. All rights reserved.