Magazine article Clinical Psychiatry News

Risk Factors Identified for Relapse in Bulimia

Magazine article Clinical Psychiatry News

Risk Factors Identified for Relapse in Bulimia

Article excerpt

ORLANDO, FLA. -- A combination of severe symptoms, extensive family involvement, and a concomitant Axis II diagnosis was a predictor of relapse and readmission among bulimia nervosa patients in a recent study.

Typically, about 30% of hospitalized patients with eating disorders will relapse and be readmitted prior to clinical recovery, so it is important to identify and address their risk factors, Sherri Y. Theoharidis, Ph.D., said at an international conference sponsored by the Academy for Eating Disorders.

She initiated her research after working in an inpatient treatment center where she saw firsthand the extent of the problem of relapse and readmission.

"For the most part, when they did return, it was with more physical deterioration and more emotional deterioration in their lives, along with disruption of work and family relationships," said Dr. Theoharidis, who is a psychologist in Gladstone, Mo.

Readmission also poses major financial hardship, as many insurance companies limit inpatient stays and coverage, she noted.

In her archival, longitudinal study of 258 anorexic and bulimic patients treated as inpatients between 1993 and 1995, she found that readmissions were similar, but occurred an average of 6 months after discharge in anorexic patients, compared with about 12 months after discharge for bulimic patients. The difference was not statistically significant.

Symptom severity, family involvement, and Axis II diagnoses did not predict length of time until readmission.

Symptom severity, as rated on a 10-point scale, was a mean of about 6.5 for both groups, indicating that the patients had fairly severe disease at admission, she reported.

Family involvement averaged about 75% in both groups. Axis II diagnoses occurred in 27% of anorexic patients and 43% of bulimic patients; 89% of those were diagnosed with borderline personality disorder. …

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