Abstract：
BACKGROUND: Epidemiological data offer conflicting views of the natural course of binge-eating disorder (BED), with large retrospective studies suggesting a protracted course and small prospective studies suggesting a briefer duration. We thus examined changes in BED diagnostic status in a prospective, community-based study that was larger and more representative with respect to sex, age of onset, and body mass index (BMI) than prior multi-year prospective studies.
METHODS: Probands and relatives with current DSM-IV BED (n = 156) from a family study of BED (\'baseline\') were selected for follow-up at 2.5 and 5 years. Probands were required to have BMI > 25 (women) or >27 (men). Diagnostic interviews and questionnaires were administered at all timepoints.
RESULTS: Of participants with follow-up data (n = 137), 78.1% were female, and 11.7% and 88.3% reported identifying as Black and White, respectively. At baseline, their mean age was 47.2 years, and mean BMI was 36.1. At 2.5 (and 5) years, 61.3% (45.7%), 23.4% (32.6%), and 15.3% (21.7%) of assessed participants exhibited full, sub-threshold, and no BED, respectively. No participants displayed anorexia or bulimia nervosa at follow-up timepoints. Median time to remission (i.e. no BED) exceeded 60 months, and median time to relapse (i.e. sub-threshold or full BED) after remission was 30 months. Two classes of machine learning methods did not consistently outperform random guessing at predicting time to remission from baseline demographic and clinical variables.
CONCLUSIONS: Among community-based adults with higher BMI, BED improves with time, but full remission often takes many years, and relapse is common.
METHODS: Probands and relatives with current DSM-IV BED (n = 156) from a family study of BED (\'baseline\') were selected for follow-up at 2.5 and 5 years. Probands were required to have BMI > 25 (women) or >27 (men). Diagnostic interviews and questionnaires were administered at all timepoints.
RESULTS: Of participants with follow-up data (n = 137), 78.1% were female, and 11.7% and 88.3% reported identifying as Black and White, respectively. At baseline, their mean age was 47.2 years, and mean BMI was 36.1. At 2.5 (and 5) years, 61.3% (45.7%), 23.4% (32.6%), and 15.3% (21.7%) of assessed participants exhibited full, sub-threshold, and no BED, respectively. No participants displayed anorexia or bulimia nervosa at follow-up timepoints. Median time to remission (i.e. no BED) exceeded 60 months, and median time to relapse (i.e. sub-threshold or full BED) after remission was 30 months. Two classes of machine learning methods did not consistently outperform random guessing at predicting time to remission from baseline demographic and clinical variables.
CONCLUSIONS: Among community-based adults with higher BMI, BED improves with time, but full remission often takes many years, and relapse is common.
摘要：
背景：流行病学数据对暴饮暴食症（BED）的自然病程提供了相互矛盾的观点，大型回顾性研究表明病程较长，小型前瞻性研究表明病程较短。因此，我们检查了BED诊断状态的变化，基于社区的研究，在性别方面规模更大、更具代表性，发病年龄,和体重指数（BMI）比之前的多年前瞻性研究。
方法：从BED的家庭研究（“基线”）中选择了患有当前DSM-IVBED的先行者和亲属（n=156），以在2.5和5年进行随访。需要具有BMI>25(女性)或>27(男性)的阳性患者。在所有时间点进行诊断性访谈和问卷调查。
结果：有随访数据的参与者（n=137），78.1%是女性，11.7%和88.3%报告识别为黑白，分别。在基线,他们的平均年龄是47.2岁,平均BMI为36.1。在2.5（和5）年，61.3%（45.7%），23.4%(32.6%)，15.3%(21.7%)的评估参与者表现完整，次阈值，没有床,分别。在随访时间点，没有参与者表现出厌食症或神经性贪食症。中位缓解时间（即无BED）超过60个月，缓解后中位复发时间(即亚阈值或完全BED)为30个月.两类机器学习方法在预测基线人口统计学和临床变量的缓解时间时并不总是优于随机猜测。
结论：在BMI较高的社区成年人中，床随着时间的推移而提高，但是完全缓解通常需要很多年，和复发是常见的。
方法：从BED的家庭研究（“基线”）中选择了患有当前DSM-IVBED的先行者和亲属（n=156），以在2.5和5年进行随访。需要具有BMI>25(女性)或>27(男性)的阳性患者。在所有时间点进行诊断性访谈和问卷调查。
结果：有随访数据的参与者（n=137），78.1%是女性，11.7%和88.3%报告识别为黑白，分别。在基线,他们的平均年龄是47.2岁,平均BMI为36.1。在2.5（和5）年，61.3%（45.7%），23.4%(32.6%)，15.3%(21.7%)的评估参与者表现完整，次阈值，没有床,分别。在随访时间点，没有参与者表现出厌食症或神经性贪食症。中位缓解时间（即无BED）超过60个月，缓解后中位复发时间(即亚阈值或完全BED)为30个月.两类机器学习方法在预测基线人口统计学和临床变量的缓解时间时并不总是优于随机猜测。
结论：在BMI较高的社区成年人中，床随着时间的推移而提高，但是完全缓解通常需要很多年，和复发是常见的。
