Anorexia nervosa and motherhood: reproduction pattern and mothering behavior of 50 women.

A follow-up carried out on an average 12.5 years after hospital contact of 151 patients with a former diagnosis of anorexia nervosa (AN), aimed at reproduction outcome. None of the 11 males had children. Fifty of the 140 women had given birth to a total of 86 children, which is approximately one third of the expected fertility. Involuntary childlessness was of the same size as found in the background population. The rate of prematurity among the offspring was twice the expected and perinatal lethality six times the expected. Mentally the mothers did well, both during pregnancy and the post partum period. They breast-fed their children for the same mean time as did other women, and the development of the children did not differ from that found in a background population. More women in the group of mothers than in the group of non-mothers had better scores of all-round functioning at follow-up.

Short stature as a possible etiological factor in anorexia nervosa.

The 21st case of concurrence of anorexia nervosa (AN) and gonadal dysgenesis (GD) or Turners syndrome is presented together with two more cases of AN in girls of short stature, but with normal chromosomes. The concurrence of AN and GD in the Danish population over a 10 year period is found not to be beyond the expected frequency. The possibility of low stature as such as an etiologic factor in AN is presented on the background of three cases. The same hypothesis has been suggested previously, but we cannot support the view of short stature as a common condition in AN patients premorbidly.

Long-term outcome of 151 cases of anorexia nervosa. The Copenhagen Anorexia Nervosa Follow-Up Study.

One hundred and fifty-one patients (140 females - 11 males) with anorexia nervosa (AN) from three departments (child psychiatry, psychiatry, and internal medicine) were re-examined 4-22 years (average 12.5 years) after their first contact with the Rigshospital in Copenhagen. During the years 1960-76 the number of referrals was on the increase, and relatively more patients were treated in the psychiatric departments at the end than at the beginning of the period. Mean age was 16.6 years at onset, 19.0 years at primary contact. Mean weight loss was 32%. Mean duration of treatment was 12 months. Differences between the three departments concern especially age, sex, and duration of treatment. Mean age at follow-up was 31.0 years (range 16-63 years) for surviving probands. Follow-up information originated from semi-structured personal interviews (in 80% of surviving probands) together with register data on all probands, supplemented by extensive hospital data. Nine patients (6%), including six who committed suicide, died on the average 7.3 years after primary contact (average age 27.1 years). The mortality rate was 0.5% per year. At follow-up one fourth of the surviving probands had AN and one fourth suffered from other psychiatric disorders, while one half were free from mental illness. There were no significant differences in outcome between the three departments. As a whole, the group experienced a social decline. It is concluded that a substantial part of this group of AN patients had a poor prognosis with a tendency towards chronicity, despite relatively long and intensive treatment, but, on the other hand, about one half of the probands seemed to be healthy and well functioning.

Death and relapse in anorexia nervosa: survival analysis of 151 cases.

The traditional historic-prospective follow-up study of anorexia nervosa patients may be well served by recent methods of statistical analysis, the so-called models for the analysis of survival data. These models are particularly suited to the sort of incomplete observations usually produced a longitudinal studies. They include methods for estimating the probability of death and relapse as a function of time. This makes possible powerful comparisons among studies and among subsamples in single studies. In the present study, 151 patients were followed-up after 4-22 yrs. The hazard of death was on average 0.5% per year, the hazard of relapse 3% per year. With both measures, the risk declined steadily after therapeutic contact.