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Relapse in anorexia nervosa

a systematic review and meta-analysis

Berends, Tamaraa; Boonstra, Nynkeb; van Elburg, Annemariea,c,d

doi: 10.1097/YCO.0000000000000453
EATING DISORDERS: Edited by Hans W. Hoek

Purpose of review Relapse is common in patients with anorexia nervosa. The aim of this study is to systematically review the existing literature on relapse in anorexia nervosa.

Recent findings A systematic literature search was conducted in PubMed, PsychInfo and CINAHL published up to April 2018. Of the 1527 studies screened, 16 studies were included in the present review.

Summary This analysis shows that, of the patients included in this review, 31% relapsed after treatment. The highest risk of relapse is during the first year after discharge and this risk continues for up to 2 years. An overview was made of all factors significantly associated with a higher risk of relapse, resulting in the following four clusters: eating disorder variables, comorbidity symptoms, process treatment variables and demographic variables. Future research on relapse prevention is necessary to further unravel the mechanisms that might lead to relapse.

aAltrecht Eating Disorders Rintveld, Zeist

bNHL Stenden University of Applied Science, Research Group Care and Innovation in Psychiatry, Leeuwarden

cUtrecht Research Group Eating Disorders

dDepartment of Social Sciences, Utrecht University, Utrecht, The Netherlands

Correspondence to Tamara Berends, RN/MSc, Wenshoek 4, 3705 WE Zeist, The Netherlands. Tel: +31 6 18879895; e-mail:

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