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- Title
An overview and investigation of relapse predictors in anorexia nervosa: A systematic review and meta‐analysis.
- Authors
de Rijk, Eline S. J.; Almirabi, Durr; Robinson, Lauren; Schmidt, Ulrike; van Furth, Eric F.; Slof‐Op 't Landt, Margarita C. T.
- Abstract
Objective: An extensive number of predictors has been examined across the literature to improve knowledge of relapse in anorexia nervosa (AN). These studies provide various recovery and relapse definitions, follow‐up durations and relapse rates. The current study summarizes these values and predictors of relapse in AN in a review and meta‐analysis. Method: The study was executed according to PRISMA guidelines. Different databases were searched and studies in which participants did not receive an official clinical diagnosis were excluded. A quality analysis was performed using the National Institute of Health's Study Quality Assessment Tool. Random‐effects meta‐analyses were conducted to summarize data. Results: Definitions of relapse and recovery were diverse. During an average follow‐up period of 31 months an average relapse rate of 37% was found. Predictive variables from 28 studies were grouped in six categories: age and sex, symptoms and behaviors, AN subtype and duration, weight or weight change, comorbidity, and personality. The studies were characterized by non‐significant and contradictory results. Meta‐analyses were performed for the predictors age, AN duration, pre‐treatment BMI, post‐treatment BMI and depression. These yielded significant effects for post‐treatment BMI and depression: higher pre‐treatment depression (SMD =.40 CI [.21–.59] and lower post‐treatment BMI (SMD = −.35 CI [−.63 to −.07]) increased relapse chances in AN. Discussion: Our results emphasized a lack of sufficiently powered studies, consistent results, and robust findings. Solely post‐treatment BMI and pre‐treatment depression predicted relapse. Future research should use uniform definitions, larger samples and better designs, to improve our understanding of relapse in AN. Public significance: Knowledge about predictors is important to understand high relapse rates. Our study performed a review and meta‐analysis of relapse predictors in AN. Related to the heterogeneity in studies examining predictors, an overview of relapse and recovery definitions, follow‐up durations and relapse rates for AN was provided. Significant effects were found for post‐treatment BMI and pre‐treatment depression. More studies with uniform definitions are needed to improve clinical implications.
- Subjects
MEDICAL databases; ONLINE information services; PSYCHOLOGY information storage &; retrieval systems; META-analysis; CONFIDENCE intervals; MEDICAL information storage &; retrieval systems; SYSTEMATIC reviews; CONVALESCENCE; DISEASE relapse; QUALITY assurance; MENTAL depression; RESEARCH funding; DESCRIPTIVE statistics; ANOREXIA nervosa; BODY mass index; MEDLINE; COMORBIDITY
- Publication
International Journal of Eating Disorders, 2024, Vol 57, Issue 1, p3
- ISSN
0276-3478
- Publication type
Article
- DOI
10.1002/eat.24059