Psychiatric disorders common in adults who have had anorexia

Many adults who were diagnosed as teenagers to be suffering from anorexia nervosa cannot work due to psychiatric disorders. A follow-up 18 years after the onset of anorexia has shown that one in four are on disability benefit or have been signed off sick. The long-term follow-up by the Sahlgrenska Academy, University of Gothenburg, does, however, show some encouraging results.

The study was initiated in 1985. A total of 51 teenagers with anorexia nervosa were studied, together with an equally large control group of healthy persons. The groups have been investigated and compared several times as the years have passed.

"This study is unique in an international perspective. It is the only study in the world that reflects the natural course of anorexia nervosa in the population", says Elisabet Wentz, Associate Professor in Child and Adolescent Psychiatry at the Sahlgrenska Academy.

The research group has published new results from the study in two scientific journals: the British Journal of Psychiatry and the International Journal of Eating Disorders.

Three women have still not recovered from anorexia, 18 years after the start of the study. Thirteen people, or around 25%, are on disability benefit or have been signed off sick for more than six months due to an eating disorder or other psychiatric disorder. Thirty-nine percent have at least one other psychiatric disorder, in addition to the eating disorder. The most common of these is obsessive‑compulsive disorder.

But the results also contain some positive surprises. "Previous studies have shown that anorexia is a diagnosis with a very poor prognosis, with as many as one in five patients dying as a result of the disease. In contrast, we have not had a single death among the subjects of our study", says Elisabet Wentz.

Other studies have also shown that infertility is a common complication for adult women who have had anorexia, as are increased risks of giving birth prematurely and of post-natal depression. The women in the two groups in this study have had essentially the same number of children, but the women who have had anorexia were younger when they had their first child. Such children had a lower birth weight than children of women in the control group.

"None of the women who had had children still suffered from an eating disorder, but it is still more common that they worry about whether their babies are putting on weight", says Elisabet Wentz.