Background Anorexia nervosa (AN) is a life-threatening psychiatric disorder associated with significant medical and psychosocial impairment. Hospital-based behavioral treatment is an effective intervention in the short-term. However, relapse rates following discharge are high and thus, there is a need to identify predictors of longitudinal outcome. The current study provides information regarding illness course and health maintenance among patients with AN over 5 years following discharge from an eating disorder inpatient unit. Methods Participants were individuals with AN who were discharged from a specialized, inpatient behaviorally-based unit. Prior to discharge, height and weight were measured and participants completed self-report measures of eating disorder severity and general psychopathology (depression, anxiety, harm avoidance). Participants were contacted annually for self-report measures of weight, eating disorder severity and clinical impairment. Outcome was defined by illness course (body mass index (BMI) and clinical impairment during the 5 years) and health maintenance (categories of weight and eating disorder symptom severity) across follow-up, using all available data. Linear mixed models were used to examine whether demographic and clinical parameters at discharge predicted BMI and clinical impairment over time. Additional analyses examined whether these variables significantly influenced an individual’s likelihood of maintaining inpatient treatment gains. Results One-hundred and sixty-eight individuals contributed data. Higher trait anxiety at discharge was associated with a lower BMI during follow-up (p = 0.012). There was a significant interaction between duration of illness and time, whereby duration of illness was associated with a faster rate of weight loss (p = 0.003) during follow-up. As duration of illness increased, there was a greater increase in self-reported clinical impairment (p = 0.011). Increased eating disorder severity at discharge was also associated with greater clinical impairment at follow-up (p = 0.004). Higher BMI at discharge was significantly associated with maintaining healthy weight across a priori BMI-based definitions of health maintenance. Conclusions Weight status (higher BMI) and duration of illness are key factors in the prognosis of AN. Higher weight targets in intensive treatments may be of value in improving outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s40337-020-00348-7.

中文翻译：

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神经性厌食症患者住院治疗后病程及健康维持的预测因素

背景 神经性厌食症 (AN) 是一种危及生命的精神疾病，与严重的医学和心理社会损害相关。医院行为治疗是短期内有效的干预措施。然而，出院后的复发率很高，因此需要确定纵向结果的预测因素。目前的研究提供了饮食失调住院病房出院后 5 年以上 AN 患者的病程和健康维护信息。方法 参与者是从专门的行为科住院病房出院的 AN 患者。出院前，测量了身高和体重，并完成了饮食失调严重程度和一般精神病理学（抑郁、焦虑、避免伤害）的自我报告测量。每年都会联系参与者，要求其自我报告体重、饮食失调严重程度和临床损伤。使用所有可用数据，根据随访期间的病程（体重指数 (BMI) 和临床损伤）和随访期间的健康维持（体重和饮食失调症状严重程度类别）来定义结果。使用线性混合模型来检查出院时的人口统计和临床参数是否可以预测随着时间的推移体重指数和临床损伤。其他分析检查了这些变量是否显着影响个体维持住院治疗收益的可能性。结果 一百六十八人贡献了数据。出院时较高的特质焦虑与随访期间较低的 BMI 相关（p = 0.012）。病程和时间之间存在显着的交互作用，即病程持续时间与随访期间体重减轻速度更快相关（p = 0.003）。随着病程的延长，自我报告的临床损伤也随之增加（p = 0.011）。出院时饮食失调严重程度的增加也与随访时更大的临床损伤相关（p = 0.004）。根据先前基于 BMI 的健康维护定义，出院时较高的 BMI 与保持健康体重显着相关。结论 体重状况（较高的 BMI）和病程是 AN 预后的关键因素。强化治疗中更高的体重目标可能对改善结果有价值。补充信息 在线版本包含可在 10.1186/s40337-020-00348-7 获取的补充材料。