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High Rates of Chronicity and Rapidity of Relapse in Patients With Bulimia Nervosa and Depression

Martin B. Keller, MD; David B. Herzog, MD; Philip W. Lavori, PhD; Ingrid L. Ott; Isabel S. Bradburn, MEd; Elizabeth M. Mahoney
Arch Gen Psychiatry. 1989;46(5):480-481. doi:10.1001/archpsyc.1989.01810050094018
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To the Editor.—  This report adds an additional year of follow-up to a longitudinal study on patients with bulimia nervosa and affective disorder, from six months1 to 18 months. Given the lack of prospective data in the literature on the course of bulimia nervosa, we designed this naturalistic study to assess the status of bulimia nervosa on a weekly basis and to concurrently follow the course of any other DSM-III2 Axis I disorder present at intake or that develops during follow-up.

Subjects and Methods.—  Subjects were recruited from a consecutive sample of female bulimic outpatients who sought treatment at the Massachusetts General Hospital Eating Disorders Unit (EDU), Boston. Thirty-one patients were selected and gave informed consent after the study procedures were explained. One woman dropped out of the study during intake. The mean age of the 30 subjects was 23.9 years, ranging from 15 to 54 years, and

REFERENCES

Herzog DB, Keller MB, Lavori PW, Ott IL:  Short term prospective study of recovery in bulimia . Psychiatry Res 1988;;23:45-55.
American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980;.
Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria for a Selected Group of Functional Disorders , ed 3. New York, Biometrics Research Division, New York State Psychiatric Institute, 1977;.
Garner DM, Olmsted MP, Polivy J:  Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia . Int J Eating Disord 1983;;2:15-34.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J:  An inventory for measuring depression . Arch Gen Psychiatry 1961;;4:561-571.
Spitzer RL, Endicott J: Schedule for Affective Disorders and Schizophrenia (SADS) , ed 3. New York, Biometrics Research Division, New York State Psychiatric Institute, 1979;.
Keller MB, Lavori PW, McDonald-Scott P, Scheftner WA, Andreasen NC, Shapiro RW, Croughan J:  Reliability of lifetime diagnoses and symptoms in patients with a current psychiatric disorder . J Psychiatr Res 1981;;16:229-240.
Keller MB, Lavori PW, Friedman B, Nielsen E, Endicott J, McDonald-Scott P, Andreasen NC:  The Longitudinal Interval Follow-up Evaluation: A comprehensive method for assessing outcome in prospective longitudinal studies . Arch Gen Psychiatry 1987;;44:540-548.

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Herzog DB, Keller MB, Lavori PW, Ott IL:  Short term prospective study of recovery in bulimia . Psychiatry Res 1988;;23:45-55.
American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980;.
Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria for a Selected Group of Functional Disorders , ed 3. New York, Biometrics Research Division, New York State Psychiatric Institute, 1977;.
Garner DM, Olmsted MP, Polivy J:  Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia . Int J Eating Disord 1983;;2:15-34.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J:  An inventory for measuring depression . Arch Gen Psychiatry 1961;;4:561-571.
Spitzer RL, Endicott J: Schedule for Affective Disorders and Schizophrenia (SADS) , ed 3. New York, Biometrics Research Division, New York State Psychiatric Institute, 1979;.
Keller MB, Lavori PW, McDonald-Scott P, Scheftner WA, Andreasen NC, Shapiro RW, Croughan J:  Reliability of lifetime diagnoses and symptoms in patients with a current psychiatric disorder . J Psychiatr Res 1981;;16:229-240.
Keller MB, Lavori PW, Friedman B, Nielsen E, Endicott J, McDonald-Scott P, Andreasen NC:  The Longitudinal Interval Follow-up Evaluation: A comprehensive method for assessing outcome in prospective longitudinal studies . Arch Gen Psychiatry 1987;;44:540-548.

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