Objective:

There is long-standing interest in how best to define stages of illness for anorexia nervosa, including remission and recovery. The authors used data from a previously published study to examine the time course of relapse over the year following full weight restoration.

Methods:

Following weight restoration in an acute care setting, 93 women with anorexia nervosa were randomly assigned to receive fluoxetine or placebo and were discharged to outpatient care, where they also received cognitive-behavioral therapy for up to 1 year. Relapse was defined on the basis of a priori clinical criteria. Fluoxetine had no impact on the time to relapse. In the present analysis, for each day after entry into the study, the risk of relapse over the following 60 days and the following 90 days was calculated and a parametric function was fitted to approximate the Kaplan-Meier estimator.

Results:

The risk of relapse rose immediately after entry into the study, reached a peak after approximately 60 days, and then gradually declined. There was no indication of an inflection point at which the risk of relapse fell precipitously after the initial peak.

Conclusions:

This analysis highlights the fact that adult patients with anorexia nervosa are at increased risk of relapse in the first months following discharge from acute care, suggesting a need for frequent follow-up and relapse prevention–focused treatment during this period. After approximately 2 months, the risk of relapse progressively decreases over time.

中文翻译：

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神经性厌食症急性治疗后复发的时间过程

客观的：

长期以来，人们一直对如何最好地定义神经性厌食症的疾病阶段（包括缓解和恢复）感兴趣。作者使用先前发表的一项研究的数据来检查完全恢复体重后一年内复发的时间过程。

方法：

在紧急护理环境中恢复体重后，93 名神经性厌食症女性被随机分配接受氟西汀或安慰剂治疗，然后出院到门诊治疗，在那里她们还接受了长达 1 年的认知行为治疗。复发是根据先验临床标准定义的。氟西汀对复发时间没有影响。在本分析中，对于进入研究后的每一天，计算随后 60 天和随后 90 天的复发风险，并拟合参数函数以近似 Kaplan-Meier 估计量。

结果：

复发风险在进入研究后立即上升，大约 60 天后达到峰值，然后逐渐下降。没有迹象表明复发风险在初始峰值后急剧下降的拐点。

结论：

该分析强调了这样一个事实，即患有神经性厌食症的成年患者在急性护理出院后的头几个月内复发的风险增加，这表明在此期间需要频繁的随访和以预防复发为重点的治疗。大约 2 个月后，复发的风险会随着时间的推移而逐渐降低。