Outcome of eating disorders in a Japanese sample: a 4- to 9-year follow-up study.

OBJECTIVE: The aim of this study was to compare the outcome of eating disorders (EDs) in Japan with that in Western countries. METHOD: Two hundred and thirty-three Japanese women with an ED were followed for 4 to 9 years. We identified fully recovered women (good outcome group), partially recovered women (intermediate outcome group) and women with an active ED (poor outcome group) based on physical, behavioural and psychological indices. RESULTS: Ninety-seven subjects were categorized as having a good outcome, 58 as intermediate and 61 as poor, and 17 had died. There was a significant difference in outcome results among the types of ED at intake. Women with both anorexia nervosa and bulimia nervosa, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, at intake had the worst recovery rates. CONCLUSIONS: These results suggest that the outcome of EDs in Japan is relatively similar to that in Western countries, irrespective of sociocultural background and health systems.

Clinical presentation and outcome of avoidant/restrictive food intake disorder in a Japanese sample.

We conducted a study of the clinical presentation and outcome in patients with avoidant/restrictive food intake disorder (ARFID), aged 15-40years, and compared this group to an anorexia nervosa (AN) group in a Japanese sample. A retrospective chart review was completed on 245 patients with feeding and eating disorders (FEDs), analyzing prevalence, clinical presentation, psychopathological properties, and outcomes. Using the DSM-5 criteria, 27 (11.0%) out of the 245 patients with a FED met the criteria for ARFID at entry. All patients with ARFID were women. In terms of eating disorder symptoms, all patients with ARFID had restrictive eating related to emotional problems and/or gastrointestinal symptoms. However, none of the ARFID patients reported food avoidance related to sensory characteristics or functional dysphagia. Additionally, none of them exhibited binge eating or purging behaviors, and none of them reported excessive exercise. The ARFID group had a significantly shorter duration of illness, lower rates of admission history, and less severe psychopathology than the AN group. The ARFID group reported significantly better outcome results than the AN group. These results suggest that patients with ARFID in this study were clinically distinct from those with AN and somewhat different from pediatric patients with ARFID in previous studies.

Comparison between the SCOFF Questionnaire and the Eating Attitudes Test in patients with eating disorders.

OBJECTIVE: The SCOFF was developed as a simple, five-question screening tool for eating disorders to be used in primary care. The aim of this study was to examine the appropriateness of each question in comparison with the Eating Attitudes Test-26. METHODS: The SCOFF and the EAT-26 were administered to 80 patients with eating disorders who had received treatment from May through October 2003 in Japan. RESULTS: The scores of the SCOFF and those of the EAT-26 were positively correlated (P<0.001), and each question of the SCOFF was strongly associated with different items of the EAT-26. The detection rates with the SCOFF of the patients with anorexia nervosa or bulimia nervosa and that of the patients with eating disorders not otherwise specified (EDNOS) were 96.2 and 48.1%, respectively. The scores of the SCOFF and the values of body mass index were significantly correlated (P=0.041), and the detection rate with the SCOFF of patients with low body weight and EDNOS was low (10%). CONCLUSION: Each question of the SCOFF has been selected appropriately for reflecting characteristics of eating disorders, although one question about body weight loss should be modified to detect patients with anorexia nervosa more accurately.