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Ten-year follow-up of adolescent-onset anorexia nervosa: personality disorders

Artikel i vetenskaplig tidskrift
Författare E. W Nilsson
Christopher Gillberg
I Carina Gillberg
Maria Råstam
Publicerad i Journal of the American Academy of Child and Adolescent Psychiatry
Volym 38
Nummer/häfte 11
Sidor 1389-1395
ISSN 0890-8567
Publiceringsår 1999
Publicerad vid Institutionen för kvinnors och barns hälsa, Avdelningen för barn- och ungdomspsykiatri
Sidor 1389-1395
Språk en
Ämnesord Adolescent, Adult, Anorexia Nervosa, Complications, Psychology, Female, Follow-Up Studies, Humans, Male, Obsessive-Compulsive Disorder, Etiology, Psychology, Personality Disorders, Etiology, Psychology, Prognosis, Social Behavior
Ämneskategorier Medicin och Hälsovetenskap, Psykiatri, Barn- och ungdomspsykiatri

Sammanfattning

OBJECTIVE: To study the development of personality disorders, especially those involving obsessions, compulsions, and social interaction problems, in a representative group of anorexia nervosa (AN) cases. METHOD: The prevalence of personality disorders, obsessive-compulsive disorder, and autism spectrum disorders at mean age 24 years (10 years after reported onset) was examined in 51 adolescent-onset AN cases recruited after community screening and 51 comparison cases matched for age, sex, and school. All 102 cases had originally been examined at age 16 years and followed up at 21 years. At 24 years, structured and validated psychiatric diagnostic interviews were performed by a psychiatrist who was blind to original diagnosis. The majority of AN cases (94%) were weight-restored. RESULTS: Personality disorders, particularly cluster C, and autism spectrum disorders were overrepresented in the AN group. Obsessive-compulsive personality disorder and/or autism spectrum disorder was diagnosed in a subgroup of AN cases in all 3 studies. This subgroup had a very poor psychosocial outcome. CONCLUSIONS: Persistent problems with obsessions, compulsions, and social interaction characterized a substantial minority of weight-restored AN cases at 10-year follow-up. These problems appear to be constitutional rather than a result of AN, and they may warrant a different treatment approach.

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