Skip to main content
Log in

Anorexia nervosa with an early onset: Selection, gender, outcome, and results of a long-term follow-up study

  • Published:
Journal of Youth and Adolescence Aims and scope Submit manuscript

Abstract

Teen-age onset has been a characteristic trait of anorexia nervosa from the early descriptions and onward. Early onset may be defined by using an age limit or by using menarche as a biological age limit. A review of the literature indicates that there are relatively more boys among patients with an extremely early onset. When patients are recruited exclusively from clinics for children or from clinics for adults, various selection biases will result, having great importance for the interpretation of the findings. Results from a Swedish long-term study are presented showing outcome in patients with different age at onset. The general trend is that early onset is predicting a better outcome, but the long-term course is far from favorable in many early onset cases. There is a risk of intractable sequelae, e.g., short stature, if anorexia patients with an early onset are allowed to run a long or chronic course of illness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Askevold, F. (1980). Anorexia nervosa hos yngre kvinner. En klinisk studie av tilstanden, behandlingen og forlöpet. (Diss.). Rigshospitalet, Oslo.

    Google Scholar 

  • Blitzer, J. E., Rollins, N., and Blackwell, A. (1961). Children who starve themselves: Anorexia nervosa.Psychosom. Med. 23: 369–383.

    PubMed  Google Scholar 

  • Bryant-Waugh, R., Knibbs, J., Fosson, A., Kaminski, Z., and Lask, B. (1988). Long term follow up of patients with early onset anorexia nervosa.Arch. Dis. Child. 63: 5–9.

    Google Scholar 

  • Cantwell, D. P., Sturzenberger, S., Burroughs, J., Salkin, B., and Green, J. K. (1977). Anorexia nervosa. An affective disorder?Arch. Gen. Psychiat. 34: 1087–1093.

    PubMed  Google Scholar 

  • Casper, R. C. (1983). On the emergence of bulimia nervosa as a syndrome.Int. J. Eat. Disord. 2: 3–16.

    Google Scholar 

  • Crisp, A. H., and Burns, T. (1983). The clinical presentation of anorexia nervosa in the male.Int. J. Eat. Disord. 2: 5–10.

    Google Scholar 

  • Crisp, A. H., Burns, T., and Bhat, A. V. (1986). Primary anorexia nervosa in the male and female: A comparison of clinical features and prognosis.Br. J. Med. Psychol. 59: 123–132.

    PubMed  Google Scholar 

  • Crisp, A. H., Hsu, L. K. G., Harding, B., and Hartshorn, J. (1980). Clinical features of anorexia nervosa: A study of a consecutive series of 102 female patients.J. Psychosom. Res. 24: 179–191.

    PubMed  Google Scholar 

  • Dally, P. (1969). Anorexia nervosa. W. Heinemann Medical Books, London.

    Google Scholar 

  • Dally, P., Gomez, J., and Isaacs, A. J. (1979).Anorexia Nervosa. W. Heinemann Medical Books, London.

    Google Scholar 

  • Fichter, M. M. (1985).Magersucht und Bulimia. Springer-Verlag, Berlin.

    Google Scholar 

  • Fosson, A., Knibbs, J., Bryant-Waugh, R., and Lask, B. (1987). Early onset anorexia nervosa.Arch. Dis. Child. 62: 114–118.

    PubMed  Google Scholar 

  • Garfinkel, P. E., and Garner, D. M. (1982).Anorexia Nervosa: A Multidimensional Perspective. Brunner/Mazel, New York.

    Google Scholar 

  • Gillberg, C., Rastam, M., and Gillberg, I. C. (1994). Anorexia nervosa: Who sees the patients and who do the patients see?Acta Paediatr. 83: 967–971.

    PubMed  Google Scholar 

  • Gillberg, I. C., Rastam, M., and Gillberg, C. (1995). Anorexia nervosa outcome: Six year controlled longitudinal study of 51 cases including a population cohort.J. Am. Acad. Child. Adolesc. Psychiat. 33: 729–739.

    Google Scholar 

  • Halmi, K. A., Casper, R. C., Eckert, E. D., Goldberg, S. C., and Davis, J. M. (1979). Unique features associated with age of onset of anorexia nervosa.Psychiat. Res. 1: 209–215.

    Google Scholar 

  • Hawley, R. M. (1985). The outcome of anorexia nervosa in younger subjects.Br. J. Psychiat. 146: 657–660.

    Google Scholar 

  • Higgs, J. F., Goodyer, I. M., and Birch, J. (1989). Anorexia nervosa and food avoidance emotional disorder.Arch. Dis. Child 64: 346–351.

    PubMed  Google Scholar 

  • Hsu, L. K., Crisp, A. H., and Harding, B. (1979). Outcome of anorexia nervosa.Lancet 1: 61–65.

    PubMed  Google Scholar 

  • Jacobs, B. W., and Isaacs, S. (1986). Pre-pubertal anorexia nervosa: A retrospective controlled study.J. Child Psychol. Psychiat. 27: 237–250.

    PubMed  Google Scholar 

  • Johnson-Sabine, E., Wood, K., Patton, G., Mann, A., and Wakeling, A. (1988). Abnormal eating attitudes in London schoolgirls—A prospective epidemiological study: Factors associated with abnormal response on screening questionnaires.Psychol. Med. 18: 615–622.

    PubMed  Google Scholar 

  • Lask, B., and Bryant-Waugh, R. (eds.) (1993).Childhood Onset Anorexia Nervosa and Related Eating Disorders. Lawrence Erlbaum Associates, Hove (UK), Hillsdale (USA).

    Google Scholar 

  • Mester, H. (1981).Anorexia Nervosa. Springer-Verlag, Berlin.

    Google Scholar 

  • Nussbaum, M., Shenker, I. R., Baird, D., and Saravay, S. (1985). Follow-up investigation in patients with anorexia nervosa.J. Pediatr. 106: 835–840.

    PubMed  Google Scholar 

  • Patton, G. C., Johnson-Sabine, E., Wood, K., Mann, A. H., and Wakeling, A. (1990). Abnormal eating attitudes in London schoolgirls—A prospective epidemiological study: Outcome at twelve month follow-up.Psychol. Med. 20: 383–394.

    PubMed  Google Scholar 

  • Rastam, M., Gillberg, C., and Garton, M. (1989). Anorexia nervosa in a Swedish urban region. A population-based study.Br. J. Psychiat. 155: 642–646.

    Google Scholar 

  • Ratnasuriya, R. H., Eisler, I., Szmukler, G. I., and Russell, G. F. (1991). Anorexia nervosa: Outcome and prognostic factors after 20 years.Br. J. Psychiat. 158: 495–502.

    Google Scholar 

  • Russell, G. F. M. (1985). Premenarchal anorexia nervosa and it sequelae.J. Psychiatr. Res. 19: 363–369.

    PubMed  Google Scholar 

  • Russell, G. F. M. (1995). Anorexia nervosa through time. In Szmukler, G. I., Dare, C., and Treasure, J. (eds.),Handbook of Eating Disorders. Theory, Treatment and Research. John Wiley & Sons, Chichester.

    Google Scholar 

  • Steinhausen, H. C., and Glanville, K. (1983). A long-term follow-up of adolescent anorexia nervosa.Acta Psychiatr. Scand. 68: 1–10.

    PubMed  Google Scholar 

  • Steinhausen, H. C., and Seidel, R. (1993). Outcome in adolescent eating disorders.Int. J. Eat. Disord. 14: 487–496.

    PubMed  Google Scholar 

  • Sturzenberger, S., Cantwell, D. P., Burroughs, J., Salkin, B., and Green J. K. (1977). A follow-up study of adolescent psychiatric inpatients with anorexia nervosa. I. The assessment of outcome.J. Am. Acad. Child Psychiat. 16: 703–715.

    Google Scholar 

  • Szmukler, G. I., and Russell, G. F. M. (1986). Outcome and prognosis of anorexia nervosa. In Brownell, K. D., and Foreyt, J. É (eds.),Handbook of Eating Disorders. Basic Books, New York.

    Google Scholar 

  • Theander, S. (1970). Anorexia nervosa: A psychiatric investigation of 94 female patients.Acta Psychiatr. Scand. Suppl. 214: 1–194.

    PubMed  Google Scholar 

  • Theander, S. (1985). Outcome and prognosis in anorexia nervosa and bulimia: Some results of previous investigations compared with those of a Swedish long-term study.J. Psychiatr. Res. 19: 493–508.

    PubMed  Google Scholar 

  • Theander, S. (1992). Chronicity in anorexia nervosa: Results from the Swedish long-term study. InThe Course of Eating Disorders. Herzog, W., Deter, H.-C., and Vandereycken, W. (eds.), Springer-Verlag, Heidelberg, Berlin.

    Google Scholar 

  • Tolstrup, K., Brinch, M., Isager, T., Nielsen, S., Nystrup, J., Severin, B., and Olesen, N. S. (1985). Long-term outcome of 151 cases of anorexia nervosa.Acta Psychiatr. Scand. 71: 380–387.

    PubMed  Google Scholar 

  • Walford, G., and McCune, N. (1991). Long-term outcome in early-onset anorexia nervosa.Br. J. Psychiatr. 159: 383–389.

    Google Scholar 

  • Warren, W. (1968). A study of anorexia nervosa in young girls.J. Child Psychol. Psychiat. 9: 27–40.

    PubMed  Google Scholar 

Download references

Authors

Additional information

Newly retired from a position as Associate Professor and Head of the Anorexia Nervosa Unit at the University of Lund, Sweden. Received M.D. from University of Lund. Research interests are course and outcome of anorexia nervosa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Theander, S. Anorexia nervosa with an early onset: Selection, gender, outcome, and results of a long-term follow-up study. J Youth Adolescence 25, 419–429 (1996). https://doi.org/10.1007/BF01537539

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01537539

Keywords

Navigation