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The Am Journal of Psych

… where are we?

Objective: The present review addresses the outcome of bulimia nervosa, effect variables, and prognostic factors. Method: A total of 79 study series covering 5,653 patients suffering from bulimia nervosa were analyzed with regard to recovery, improvement, chronicity, crossover to another eating disorder, mortality, and comorbid psychiatric disorders at outcome. Forty-nine studies dealt with prognosis only. Final analyses on prognostic factors were based on 4,639 patients. Results: Joint analyses of data were hampered by a lack of standardized outcome criteria. There were large variations in the outcome parameters across studies. Based on 27 studies with three outcome criteria (recovery, improvement, chronicity), close to 45% of the patients on average showed full recovery of bulimia nervosa, whereas 27% on average improved considerably and nearly 23% on average had a chronic protracted course. Crossover to another eating disorder at the follow-up evaluation in 23 studies amounted to a mean of 22.5%. The crude mortality rate was 0.32%, and other psychiatric disorders at outcome were very common. Among various variables of effect, duration of follow-up had the largest effect size. The data suggest a curvilinear course, with highest recovery rates between 4 and 9 years of follow-up evaluation and reverse peaks for both improvement and chronicity, including rates of crossover to another eating disorder, before 4 years and after 10 years of follow-up evaluation. For most prognostic factors, there was only conflicting evidence. Conclusions: One-quarter of a century of specific research in bulimia nervosa shows that the disorder still has an unsatisfactory outcome in many patients. More refined interventions may contribute to more favorable outcomes in the future.

http://ajp.psychiatryonline.org/cgi/content/short/appi.ajp.2009.09040582v1?rss=1

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BodyTalk II

 A Chance to Heal  is holding a seminar for educators in the Philly area concentrating on supporting healthy Body-Self Image issues and there is still time to register:

A professional educational opportunity for those who influence 5th-12th grade girls and boys.

Students are bombarded with negative messages influencing their resilience and self-image. Media forces encourage critical inner voices that predispose students to problems with drugs, alcohol and/or body image. This symposium will empower you to support positive thinking and confront these messages head-on.

 Thursday, February 5, 2009 (Snow Date: February 19th) 3:30-5:30pm

Yarnall Auditorium: Germantown Friends School 31 W. Coulter Street, Philadelphia PA Registration: $10 – Register Now, Seating is Limited! Professional CE Credit Available for Educators  and Registered Dietitians.

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