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Table 2 Definitions of relapse, according to individual studies identified by the literature search

From: What happens after treatment? A systematic review of relapse, remission, and recovery in anorexia nervosa

Authors Criteria Duration Study quality
Definitions of Relapse
 Isager et al., 1985 [33] Loss of ≥15% of weight acquired during course of treatment (if resulting in weight ≤50 kg) Any point in time within a 1 year period Good
 Martin, 1985 [28] If the patient required further psychiatric treatment after discharge during follow–up period Not specified Fair
 Norring and Sohlberg, 1993 [34] “Ill” defined as having an eating disorder Not specified Good
 Eckert et al., 1995 [29] Loss of ≥15% of average body weight (based on Metropolitan Height-Weight Chart, 1959), after achieving normal body weight Any point after achieving normal weight during inpatient treatment or the follow up period Good
 Strober et al., 1997 [4] Full (“syndromal”) relapse: weight <85% of ideal body weight and recurrence of psychological symptoms
Partial (“subsyndromal”) relapse: recurrence of psychological symptoms but ≥85% of ideal body weight
Not specified Good
 Fichter and Quadflieg, 1999 [21] Outcome “poor” defined using Morgan-Russell criteria Not specified Fair
 Pike 1998 [8] BMI ≤ 18.5 or weight ≤85% of ideal body weight; a minimum 1 SD increase on the Eating Disorder Evaluation; loss of menstrual functioning if it has been previously normal; increase in restriction leading to weight loss; and possibly increased binge eating, compensatory behavior, or associated medical problems Not specified Fair
 Herzog, et al., 1999 [32] Return to full criteria symptoms and/or Psychiatric Status Rating (PSR) score of 5 or 6 8 weeks following a state of full recovery Good
 Lowe et al., 2001 [22] Outcome “poor” defined using Morgan-Russell criteria and PSR score of 5 or 6 Not specified Good
 Kordy et al., 2002 [10] Change from partial or full remission to full syndrome according to DSM-IV Not specified Good
 Carter, et al., 2004 [15] BMI below 17.5 and/or at least one episode of binge eating/purging behavior per week 3 consecutive months Good
 Keel, et al., 2005 [17] Return to full criteria symptoms and/or PSR score of 5 or 6 Not specified Good
 Walsh et al., 2006 [14] BMI below 16.5 for 2 consecutive weeks, or severe medical complications, or risk of suicide, or development of another psychiatric disorder requiring treatment 2 consecutive weeks (low BMI) Good
 Eisler et al., 2007 [20] Outcome “poor” defined using Morgan-Russell criteria Not specified Good
 Clausen, 2008 [18] PSR score ≥3 3 months Good
 Bodell and Mayer, 2011 [24] Poor outcome, BMI ≤18.5 (using modified Morgan-Russell criteria) Not specified Fair
 Helverskov, et al., 2010 [16] Return to full criteria symptoms and/or PSR score of 5 or 6 Not specified Good
 Carter et al., 2012 [7] BMI < 17.5 or at least one episode of binge eating/purging behavior per week 3 consecutive months Good
 McFarlane et al., 2015 [31] AN: BMI < 18.5
AN-BP: average 4 episodes of bingeing and/or vomiting per month, or BMI < 18.5
3 consecutive months Good