A 4-year epidemiological study of typical and atypical eating disorders: preliminary evidence for subgroups of atypical eating disorders with different natural outcomes

摘要

Backgrounds We designed a two-step prospective study aiming to detect cases with full and atypical eating disorders (EDs) in a population of female high-school students (first step) and to assess their natural outcome after a 4-year time period (second step). Methods In the first step, we screened female students in their first year of high school by means of the EDI-2 and GHQ-28 questionnaires. Those students identified as being at risk for an ED underwent a psychiatric interview. In the second step, 4 years later, we tested schoolgirls in their last year of high school by adopting the same procedure as the first step. Results 140 subjects participated in both steps. In the first step, we identified one subject with full-blown bulimia nervosa (BN), one with partial-syndrome BN, two with subclinical BN and eight with subclinical anorexia nervosa (AN). At the reassessment 4 years later, none of the girls had received any form of help. The full-blown BN case, the partial-syndrome BN case and one of the subclinical AN cases persisted unchanged; one of the subclinical BN cases shifted to subclinical AN; the remaining subclinical cases remitted spontaneously. Moreover, we identified 12 new cases of EDs. Conclusions Present findings provide the first evidence that subclinical AN and subclinical BN represent unstable states that can spontaneously remit over time.