[The outcome of anorexia nervosa: a prospective study of 129 patients evaluated at least 4 years after their first admission].

Abstract

This is a follow-up study with an interval of 4 to 20 years (mean: 11 years) of 146 cases of anorexia nervosa of which 129 could be contacted. The investigation is based on various measures: BPRS scale, HSCL, a chart of clinical assessment made by the examiner (10 items), a global self-evaluation by the patient, a clinical interview. Results and factors of prognosis are discussed. Our findings stress the importance of good outcome on a long term basis but also the potential severity of anorexia nervosa with both a death risk and a risk of chronicity. It becomes obvious that the major challenge of anorectic conduct are the residual disturbances of the personality. These disturbances are mainly difficulties in investing and the antagonism between the objectal inclination of these patients and the need to protect their narcissistic balance. A posteriori we understand the defensive meaning of the anorectic conduct and its value as a reorganizing of objectal relations. The psychopathological significance of this conduct, its stakes and its therapeutical consequences are discussed.