Predictors of Rapid Relapse in Bulimia Nervosa

ObjectiveRelapse remains a significant concern in bulimia nervosa, with some patients relapsing within months of treatment completion. The purpose of the study was to identify predictors of relapse within the first 6 months following treatment. MethodThe 116 participants were bingeing and/or vomiting8 times per month before day hospital (DH), and had2 episodes per month in the last month of DH and the first month after DH. Rapid relapse was defined as8 episodes per month for 3 months starting within 6 months. ResultsThe rate of rapid relapse was 27.6%. Patients who relapsed soon after DH had higher frequencies of bingeing and vomiting before treatment, engaged in less body avoidance before treatment and were more likely to be slow responders to treatment. Weight and shape concerns and body checking were not significant predictors. DiscussionMore frequent bulimic symptoms accompanied by less body avoidance may indicate an entrenchment in the illness which in turn augurs a labored and transient response to DH treatment that is difficult to sustain after intensive treatment ends. (c) 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:337-340)