Eating Disorders and Obesity: A Comprehensive Handbook

By Christopher G. Fairburn; Kelly D. Brownell | Go to book overview

40
Course and Outcome of Anorexia
Nervosa and Bulimia Nervosa

PATRICK F. SULLIVAN

Accurate depiction of the course and outcome of a disorder is fundamental to its characterization. These are critical data for clinicians and researchers alike. “Course” refers to the temporal pattern of an illness from onset to subsequent recovery, partial recovery, nonrecovery, or death. “Outcome” describes the state of affected individuals at some specified time after the development of a disorder. Both can be assessed in multiple ways. The temporal dimension is integral to both course and outcome.

Imbedded within these basic definitions, however, are a number of vexing complexities, particularly when applied to anorexia nervosa and bulimia nervosa. First, there are fundamental uncertainties about whether the International Classification of Diseases (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) nosologies accurately characterize anorexia nervosa and bulimia nervosa. The experience in many eating disorder services is that a substantial proportion of individuals presenting for care have “subthreshold eating disorders” that do not quite fit the ICD-10 or DSM-IV criteria for anorexia nervosa or bulimia nervosa. (Chapter 30 discusses atypical eating disorders, including subthreshold and partial syndromes.) Second, the potential diagnostic overlap between anorexia nervosa and bulimia nervosa remains incompletely understood, thereby adding a further level of complexity. Third, “outcome” for anorexia nervosa and bulimia nervosa has to be defined across a number of relevant domains. Fourth, the extant literature complicates the task of characterizing course and outcome by often neglecting the temporal dimension and by relying on clinical samples (particularly since there is ample evidence of profound referral bias for both disorders).

To clarify the concepts “course and outcome,” Figure 40.1 schematically presents a partial set of possibilities. At some “premorbid” time, no one has anorexia nervosa or bulimia nervosa. At the “postonset” time, all cases of anorexia nervosa and bulimia nervosa have developed (depicted by the arrows from the premorbid “well” box to the postonset anorexia nervosa and bulimia nervosa boxes). Subsequently, at “follow-up,”

-226-

Notes for this page

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this book

This book has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this book

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this page

Cited page

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited page

Bookmark this page
Eating Disorders and Obesity: A Comprehensive Handbook
Table of contents

Table of contents

Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this book

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen
/ 632

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.