Ten-Year Follow Up of Adolescent Onset Anorexia Nervosa: Personality Disorders

E. Wentz Nilsson, C. Gillberg, Christopher Gillberg, Carina Gillberg and M. Rastam, Journal of the American Academy of Child and Adolescent Psychiatry, November 1999, Volume 38, Issue 11, Pages 1389.

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 over represented 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 psychological outcome.Using the labels identified by the student, the examiner asks the student which cues he or she used to identify the emotions.