Anorexia nervosa is a devastating eating disorder and determining a path to recovery is essential. In this study, the researchers sought to find the “point of rarity” -a point in remission in which the patient is unlikely to relapse in order to help determine at what point in remission a patient could be considered to be recovered. The study included 96 weight-restored patients with remitted anorexia nervosa who were treated with 60 mg/day of fluoxetine or placebo and followed up for 1 year or until relapse. Of the 96 patients, 44 were considered to have relapsed, with 20 of those patients showing signs of severe deterioration. Unfortunately, in this study, unlike previous studies, fluoxetine was not shown to extend the time to relapse compared to placebo. Kaplan-Meier curves show the highest risk of relapse at about 2 months after study initiation (and concomitant discharge from inpatient care), with a steady decline in risk over the subsequent days. Thus, the longer a patient went without relapsing, the lower their risk of subsequent relapse and no “point of rarity” could be identified. Although these data are unable to pinpoint a point in remission when a patient can be considered recovered, they do add to our understanding of the road to recovery from anorexia nervosa.
Walsh BT et al. Am J Psychiatry 2021;00:1-5. Abstract