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BMC Psychiatry
Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Rate, timing and predictors of relapse in patients with anorexia nervosa following a relapse prevention program: a cohort study

Authors: Tamara Berends, Berno van Meijel, Willem Nugteren, Mathijs Deen, Unna N. Danner, Hans W. Hoek, Annemarie A. van Elburg

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

Background

Relapse is common among recovered anorexia nervosa (AN) patients. Studies on relapse prevention with an average follow-up period of 18 months found relapse rates between 35 and 41 %. In leading guidelines there is general consensus that relapse prevention in patients treated for AN is a matter of essence. However, lack of methodological support hinders the practical implementation of relapse prevention strategies in clinical practice. For this reason we developed the Guideline Relapse Prevention Anorexia Nervosa. In this study we examine the rate, timing and predictors of relapse when using this guideline.

Method

Cohort study with 83 AN patients who were enrolled in a relapse prevention program for anorexia nervosa with 18 months follow-up. Data were analyzed using Kaplan-Meijer survival analyses and Cox regression.

Results

Eleven percent of the participants experienced a full relapse, 19 % a partial relapse, 70 % did not relapse. Survival analyses indicated that in the first four months of the program no full relapses occurred. The highest risk of full relapse was between months 4 and 16. None of the variables remained a significant predictor of relapse in the multivariate Cox regression analysis.

Conclusion

The guideline offers structured procedures for relapse prevention. In this study the relapse rates were relatively low compared to relapse rates in previous studies. We recommend that all patients with AN set up a personalized relapse prevention plan at the end of their treatment and be monitored at least 18 months after discharge. It may significantly contribute to the reduction of relapse rates.
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Metadata
Title
Rate, timing and predictors of relapse in patients with anorexia nervosa following a relapse prevention program: a cohort study
Authors
Tamara Berends
Berno van Meijel
Willem Nugteren
Mathijs Deen
Unna N. Danner
Hans W. Hoek
Annemarie A. van Elburg
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-1019-y

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