PROGNOSIS IN ANOREXIA-NERVOSA AS INFLUENCED BY CLINICAL FEATURES, TREATMENT AND SELF-PERCEPTION

Abstract

An investigation of 42 patients with anorexia nervosa treated a mean of 31.7 mo. earlier was conducted to determine factors related to prognosis. Clinical features, treatment (behavior modification, medical and psychologic therapy) and self-perception (with a distorting photographic technique) were studied. Clinical outcome was assessed as excellent in 7, much improved in 14, symptomatic in 13 and poor in 8. Analysis of variance showed that vomiting , bulimia, poor educational/vocational adjustment and higher global clinical score were associated with a poor prognosis. There were no differences at follow-up between patients treated by behavior modification and those treated by other methods; behavior modification, while not harmful, may not provide long-term benefits. Self-estimates of body size were highly predictive of outcome; all patients with a poor outcome overestimated their size. Patients with only marginal improvement might be helped by treatment directed to self-perceptual disturbances.