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A naturalistic, long-term follow-up of purging disorder

Published online by Cambridge University Press:  15 January 2020

K. Jean Forney Open the ORCID record for K. Jean Forney [Opens in a new window] ,
Ross D. Crosby Open the ORCID record for Ross D. Crosby [Opens in a new window] ,
Tiffany A. Brown Open the ORCID record for Tiffany A. Brown [Opens in a new window] ,
Kelly M. Klein  and
Pamela K. Keel
K. Jean Forney*
Affiliation:
Department of Psychology, Ohio University, Athens, Ohio, USA
Ross D. Crosby
Affiliation:
Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
Tiffany A. Brown
Affiliation:
Department of Psychiatry, University of California San Diego, San Diego, California, USA
Kelly M. Klein
Affiliation:
VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
Pamela K. Keel
Affiliation:
Department of Psychology, Florida State University, Tallahassee, Florida, USA
*
Author for correspondence: K. Jean Forney, E-mail: forney@ohio.edu
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Abstract

Background

The DSM-5 introduced purging disorder (PD) as an other specified feeding or eating disorder characterized by recurrent purging in the absence of binge eating. The current study sought to describe the long-term outcome of PD and to examine predictors of outcome.

Methods

Women (N = 84) who met research criteria for PD completed a comprehensive battery of baseline interview and questionnaire assessments. At an average of 10.24 (3.81) years follow-up, available records indicated all women were living, and over 95% were successfully located (n = 80) while over two-thirds (n = 58) completed follow-up assessments. Eating disorder status, full recovery status, and level of eating pathology were examined as outcomes. Severity and comorbidity indicators were tested as predictors of outcome.

Results

Although women experienced a clinically significant reduction in global eating pathology, 58% continued to meet criteria for a DSM-5 eating disorder at follow-up. Only 30% met established criteria for a full recovery. Women reported significant decreases in purging frequency, weight and shape concerns, and cognitive restraint, but did not report significant decreases in depressive and anxiety symptoms. Quality of life was impaired in the physical, psychological, and social domains. More severe weight and shape concerns at baseline predicted meeting criteria for an eating disorder at follow-up. Other baseline severity indicators and comorbidity did not predict the outcome.

Conclusions

Results highlight the severity and chronicity of PD as a clinically significant eating disorder. Future work should examine maintenance factors to better adapt treatments for PD.

Keywords

Eating disorderfollow-uppurging disorderother specified feeding or eating disorderoutcome
Type
Original Articles
Information
Psychological Medicine , Volume 51 , Issue 6 , April 2021 , pp. 1020 - 1027
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Copyright
Copyright © Cambridge University Press 2020

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