Long‐term follow up of hospitalized pediatric anorexia nervosa restricting type

Background Information on long‐term follow up of childhood‐onset anorexia nervosa is scarce. This study investigated long‐term (>10 years) course, outcome and prognostic factors for hospitalized childhood‐onset anorexia nervosa restricting type ( ANR ). Methods Forty‐one ANR girls admitted to a single regional center participated. Median age at first admission was 13.3 years (range, 8.6–15.6 years). The longitudinal clinical course was retrospectively determined for a median follow‐up period of 17.1 years (range, 10.4–21.1 years). We analyzed physical, psychological, and social variables to predict partial remission ( PR ) and full remission ( FR ). Results The completion rate of follow up >10 years was high at 97%. At final evaluation ( n = 38), distribution of prognosis was as follows: FR , n = 27 (71%); PR , n = 6 (16%); and non‐remission, n = 5 (13%). The cumulative ratio of PR and FR increased during the first 5–6 years, and gradually reached a plateau at around 10 years. More than 10 years after the onset, one patient eventually achieved FR , and one patient died. Seven patients were rehospitalized and two died due to suicide during the entire follow up. On multivariate analysis, family disorders/problems rating score was a significant predictor of PR and FR . Conclusions This study included hospitalized ANR children aged ≤15 years, the youngest cohort ever reported. Long‐term prognosis is generally favorable, but the mortality rate was 5%. Careful long‐term follow up >10 years is needed to evaluate outcome of childhood‐onset ANR , and family therapy is important in high‐risk patients with family disorders/problems.