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Tijdschrift voor Psychiatrie 42 (2000) 3, 145 - 155

New research

Characteristics and treatment history of patients with chronic eating disorders

G. Noordenbos, A. Oldenhave, N. Terpstra, J. Muschter

background Little is known about patients with chronic eating disorders. The Dutch Foundation of Anorexia and Bulimia Nervosa asked 82 patients whether they had an eating disorder for ten years or longer, and whether they wanted to fill in a questionnaire about it.
aims To obtain information about the characteristics of chronic eating disorders, the consequences, the treatment history, the evaluation of treatment and the degree of recovery.
methods 48 chronic patients (all women) requested a questionnaire; 41 were completed and returned.
results The mean age was 34 years and the mean duration of the eating disorder was 15.2 years. 44% had anorexia nervosa (an), 15% bulimia nervosa (bn) and 41% alternated between an and bn. Their lowest Body Mass Index (bmi) was 14.8. They had huge fluctuations in their weight and bmi. The eating disorder had severe physical, psychological and social consequences. Nearly all patients (95%) had consulted their general practitioner about complaints related to their eating disorder. Only 60% was diagnosed in a late stage. Treatment by the general practitioner was not effective. Sooner or later they were referred to a general or psychiatric hospital, where they received various treatments from different therapists.
conclusion Most treatments were not effective, therefore the patients lost their trust in the treatment and saw themselves as incurable. Only 8% of the patients recovered, 25% improved to some extent and 67% stayed ill. Most patients wanted a new treatment, but only 30% believed they could improve. Treatment possibilities for patients with chronic eating disorders have to be improved.

keywords anorexia & bulimia nervosa, chronicity, eating disorders, recovery, treatment