Evidence against palliative care in long-term eating disorders

Because recovery from eating disorders is often a long process, and fewer than half of adults end up recovering from anorexia or bulimia, some have argued that eating disorders can become chronic and that after the eating disorder has been present for a decade, care should focus on quality of life, rather than on symptom remission.

However, results from a study conducted at Massachusetts General Hospital in Boston, investigating early and long-term recovery of those with anorexia and bulimia, provide evidence against beginning palliative care in most cases.

Because of a lack of studies investigating recovery beyond 20 years of follow-up, Kamryn T. Data recovery hardware Eddy, PhD, from Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues assessed women with anorexia or bulimia at both 9 years and 20 to 25 years of follow-up (mean [SD], 22.10 [1.10] years; 1987-2013). Best database software The women were participants in the Massachusetts General Hospital Longitudinal Study of Anorexia and Bulimia Nervosa with structured clinical interviews (Longitudinal Interval Follow-Up Evaluation of Eating Disorders [LIFE-EAT-II]).

Of an initial sample size of 246 participants, 18 died before 20 to 25 years’ follow-up. Database gui Of the 228 survivors, 176 (77%) participated in the 20- to 25-year follow-up study, 37 (16%) were contacted but declined participation, and 15 (7%) were lost to follow-up (vital status was confirmed through the National Death Index, but the participants could still not be located or invited for follow-up).

During wave 1 of the study, which began in 1987, participants were interviewed every 6 to 12 months for a mean of 9.1 (1.6) years. Data recovery technician During wave 2 of the study, which began in 2011, surviving participants were contacted between 20 to 25 years after study entry for a 1-time follow-up.

The researchers found that at 22-year follow-up, 68.2% of those with bulimia and 62.8% of those with anorexia had recovered. Database engine tuning advisor At 9-year follow-up, 68.2% of those with bulimia had recovered, but only 31.4% of those with anorexia had recovered. Data recovery rates Early recovery was associated with a higher likelihood of long-term recovery in anorexia (odds ratio [OR], 10.5; 95% confidence interval [CI], 3.77-29.28; McNemar χ 2 1 = 31.39; P <.01), but not in bulimia (OR, 1.0; 95% CI, 0.49-2.05; McNemar χ 2 1 = 0; P =1.0).

At 22 years, about two-thirds of those with anorexia and bulimia had recovered. Database developer salary Although recovery from bulimia happened earlier, recovery from anorexia continued long-term even in those who were not recovered at 9 years.

Database backup and recovery This finding “[argues] against the implementation of palliative care for most individuals with eating disorders,” the authors wrote.

“In contrast to the extant literature characterizing eating disorders as chronic illnesses, our longitudinal data demonstrate that continued symptom improvement and meaningful recovery are possible in anorexia nervosa beyond the first decade of follow-up. Yale b database For bulimia nervosa, if recovery is not observed by 9-year follow-up, it is less likely to occur in the subsequent decade,” the researchers concluded.

• The sam ple was first gathered between 1987 and 1991, so it is not known what effect more modern treatments would have had on the participants.