The prognostic value of initial EDI scores in anorexia nervosa patients: a prospective follow-up study of 5-10 years

Aim. To study in a prospective manner the long-term prognostic value of the initially recorded Eating Disorder Inventory (EDI) scores in anorexia nervosa (AN) patients. Methods. The 5-10-year outcome of 26 consecutive malnourished AN patients was prospectively recorded according to the initial EDI score. We selected only patients with full 6-month assessments for more than 5 years (mean 8.5 years). Eating behavior, quality of life, autonomy and insight capacity were prospectively assessed by the Morgan-Russell scale and a semi-structured interview. At the end of follow-up, 13 patients recovered and the 13 others had a poor outcome. Results. In monovariate analyses, high initial EDI total score (P < .0007) and high initial scores for perfectionism (P < .001), ineffectiveness (P < .002), interpersonal distrust (P < .004), interoceptive awareness (P < .03) and drive for thinness (P < .05) were significantly associated with a poor prognosis 5-10 years afterward. in a multivariate analysis, only high initial scores for perfectionism (F = 8.43; P = 0.008) and interpersonal distrust (F = 7.46; P = 0,012) were significantly associated with illness severity. Discussion. High EDI total score and subscales for perfectionism and interpersonal distrust could predict a long-term severe outcome in AN. (C) 2001 Editions scientifiques et medicales Elsevier SAS.