Stressful life events predict eating disorder relapse following remission: Six-year prospective outcomes

Carlos M. Grilo, Maria E. Pagano, Robert L. Stout, John C. Markowitz, Emily Ansell, Anthony Pinto, Mary C. Zanarini, Shirley Yen, Andrew E. Skodol

Research output: Contribution to journalReview article

24 Citations (Scopus)

Abstract

Objective: To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not-otherwise-specified (EDNOS) and test for the effects of stressful life events (SLE) on relapse after remission from these eating disorders. Method: 117 female patients with BN (N = 35) or EDNOS (N = 82) were prospectively followed for 72 months using structured interviews performed at baseline, 6- and 12-months, and then yearly thereafter. ED were assessed with the structured clinical interview for DSM-IV, and monitored over time with the longitudinal interval follow-up evaluation. Personality disorders were assessed with the diagnostic interview for DSM-IV-personality-disorders, and monitored over time with the follow-along-version. The occurrence and specific timing of SLE were assessed with the life events assessment interview. Cox proportional-hazard-regression-analyses tested associations between time-varying levels of SLE and ED relapse, controlling for comorbid psychiatric disorders, ED duration, and time-varying personality-disorder status. Results: ED relapse probability was 43%; BN and EDNOS did not differ in time to relapse. Negative SLE significantly predicted ED relapse; elevated work and social stressors were significant predictors. Psychiatric comorbidity, ED duration, and time-varying personality-disorder status were not significant predictors. Discussion: Higher work and social stress represent significant warning signs for triggering relapse for women with remitted BN and EDNOS.

Original languageEnglish (US)
Pages (from-to)185-192
Number of pages8
JournalInternational Journal of Eating Disorders
Volume45
Issue number2
DOIs
StatePublished - Mar 1 2012

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Bulimia Nervosa
Personality Disorders
Recurrence
Interviews
Diagnostic and Statistical Manual of Mental Disorders
Psychiatry
Feeding and Eating Disorders
Comorbidity
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health

Cite this

Grilo, Carlos M. ; Pagano, Maria E. ; Stout, Robert L. ; Markowitz, John C. ; Ansell, Emily ; Pinto, Anthony ; Zanarini, Mary C. ; Yen, Shirley ; Skodol, Andrew E. / Stressful life events predict eating disorder relapse following remission : Six-year prospective outcomes. In: International Journal of Eating Disorders. 2012 ; Vol. 45, No. 2. pp. 185-192.
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abstract = "Objective: To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not-otherwise-specified (EDNOS) and test for the effects of stressful life events (SLE) on relapse after remission from these eating disorders. Method: 117 female patients with BN (N = 35) or EDNOS (N = 82) were prospectively followed for 72 months using structured interviews performed at baseline, 6- and 12-months, and then yearly thereafter. ED were assessed with the structured clinical interview for DSM-IV, and monitored over time with the longitudinal interval follow-up evaluation. Personality disorders were assessed with the diagnostic interview for DSM-IV-personality-disorders, and monitored over time with the follow-along-version. The occurrence and specific timing of SLE were assessed with the life events assessment interview. Cox proportional-hazard-regression-analyses tested associations between time-varying levels of SLE and ED relapse, controlling for comorbid psychiatric disorders, ED duration, and time-varying personality-disorder status. Results: ED relapse probability was 43{\%}; BN and EDNOS did not differ in time to relapse. Negative SLE significantly predicted ED relapse; elevated work and social stressors were significant predictors. Psychiatric comorbidity, ED duration, and time-varying personality-disorder status were not significant predictors. Discussion: Higher work and social stress represent significant warning signs for triggering relapse for women with remitted BN and EDNOS.",
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Grilo, CM, Pagano, ME, Stout, RL, Markowitz, JC, Ansell, E, Pinto, A, Zanarini, MC, Yen, S & Skodol, AE 2012, 'Stressful life events predict eating disorder relapse following remission: Six-year prospective outcomes', International Journal of Eating Disorders, vol. 45, no. 2, pp. 185-192. https://doi.org/10.1002/eat.20909

Stressful life events predict eating disorder relapse following remission : Six-year prospective outcomes. / Grilo, Carlos M.; Pagano, Maria E.; Stout, Robert L.; Markowitz, John C.; Ansell, Emily; Pinto, Anthony; Zanarini, Mary C.; Yen, Shirley; Skodol, Andrew E.

In: International Journal of Eating Disorders, Vol. 45, No. 2, 01.03.2012, p. 185-192.

Research output: Contribution to journalReview article

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T1 - Stressful life events predict eating disorder relapse following remission

T2 - Six-year prospective outcomes

AU - Grilo, Carlos M.

AU - Pagano, Maria E.

AU - Stout, Robert L.

AU - Markowitz, John C.

AU - Ansell, Emily

AU - Pinto, Anthony

AU - Zanarini, Mary C.

AU - Yen, Shirley

AU - Skodol, Andrew E.

PY - 2012/3/1

Y1 - 2012/3/1

N2 - Objective: To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not-otherwise-specified (EDNOS) and test for the effects of stressful life events (SLE) on relapse after remission from these eating disorders. Method: 117 female patients with BN (N = 35) or EDNOS (N = 82) were prospectively followed for 72 months using structured interviews performed at baseline, 6- and 12-months, and then yearly thereafter. ED were assessed with the structured clinical interview for DSM-IV, and monitored over time with the longitudinal interval follow-up evaluation. Personality disorders were assessed with the diagnostic interview for DSM-IV-personality-disorders, and monitored over time with the follow-along-version. The occurrence and specific timing of SLE were assessed with the life events assessment interview. Cox proportional-hazard-regression-analyses tested associations between time-varying levels of SLE and ED relapse, controlling for comorbid psychiatric disorders, ED duration, and time-varying personality-disorder status. Results: ED relapse probability was 43%; BN and EDNOS did not differ in time to relapse. Negative SLE significantly predicted ED relapse; elevated work and social stressors were significant predictors. Psychiatric comorbidity, ED duration, and time-varying personality-disorder status were not significant predictors. Discussion: Higher work and social stress represent significant warning signs for triggering relapse for women with remitted BN and EDNOS.

AB - Objective: To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not-otherwise-specified (EDNOS) and test for the effects of stressful life events (SLE) on relapse after remission from these eating disorders. Method: 117 female patients with BN (N = 35) or EDNOS (N = 82) were prospectively followed for 72 months using structured interviews performed at baseline, 6- and 12-months, and then yearly thereafter. ED were assessed with the structured clinical interview for DSM-IV, and monitored over time with the longitudinal interval follow-up evaluation. Personality disorders were assessed with the diagnostic interview for DSM-IV-personality-disorders, and monitored over time with the follow-along-version. The occurrence and specific timing of SLE were assessed with the life events assessment interview. Cox proportional-hazard-regression-analyses tested associations between time-varying levels of SLE and ED relapse, controlling for comorbid psychiatric disorders, ED duration, and time-varying personality-disorder status. Results: ED relapse probability was 43%; BN and EDNOS did not differ in time to relapse. Negative SLE significantly predicted ED relapse; elevated work and social stressors were significant predictors. Psychiatric comorbidity, ED duration, and time-varying personality-disorder status were not significant predictors. Discussion: Higher work and social stress represent significant warning signs for triggering relapse for women with remitted BN and EDNOS.

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