Table 2 Sample of definitions of relapse, remission, and recovery in eating disorder research
From: Eating disorder outcomes: findings from a rapid review of over a decade of research
References | Diagnostic group/s | Assessment period | Determinant/s | Definitions |
|---|---|---|---|---|
Relapse | ||||
Agras et al. [21] | ED | Every 3Â months to 4Â years | EDEa | Symptoms for any ED diagnosis determined by EDEa |
Castellini et al. [7] | ED | Every 3Â years to 6Â years | Diagnosis | Return to a full syndromal or EDNOS criteria after a period of remission [32] |
Stice et al. [33] | ED | Every year to 8 years | Diagnosis | Meeting criteria after ≥ 1 month recovery [34] |
Carter et al. [35] | AN | 1 year | BMI or behaviours | BMI ≤ 17.5 (3 months) or at least one episode of binge-purge behaviour per week (3 months) |
Berends et al. [36] | AN | 1.5 years | BMI & diagnosis | Full: BMI < 18.5 for adults and BMI <  − 1 SD for adolescents and full recurrence of core diagnostic symptoms (DSM-IV) assessed by clinical team Partial: Re-occurrence of core diagnostic symptoms (DSM-IV) assessed by clinical team |
Le Grange et al. [30] | AN | Every year to 4 years | %EBWb | < 87% EBWb |
Remission | ||||
Walker et al. [37] | ED | 1Â week | EATc | Within 1 SD of community norms on the EATc [38] |
Custal et al. [39] | ED | 4Â weeks | Behaviours & psychology | Full: Absence of binging and purging (laxatives and/or vomiting) behaviours (1Â month) and psychological improvement measured by clinical questionnaire Partial: Substantial symptomatic improvement but presence of residual symptoms (reduction of at least 50% of bulimic symptoms) [40] |
Fernández-Aranda et al. [41] | ED | 16 weeks | Diagnosis | Full: Absence of diagnostic symptoms (DSM-V) (1 month) assessed by clinical team Partial: Substantial symptomatic improvement but with residual symptoms assessed by clinical team |
Colton et al. [42] | ED | 1Â year | Diagnosis or behaviours | No reported disturbed eating behaviour or absence of diagnostic symptoms |
Tomba et al. [43] | ED | 1 year | Diagnosis, BMI, behaviours, EATc | Absence of diagnosis (DSM-IV-TR), BMI, absence of binge-eating, purging, or fasting (3 month), EATc < 30 [28] |
Johnston et al. [26] | ED | Every 6Â months to 1Â year | EDEa & diagnosis | Absence of diagnostic criteria as determined by the EDEa and clinical team at 12Â month review |
Helverskov et al. [44] | ED | 2.5Â years | Symptoms | Full: Absence of symptoms or the presence of only residual symptoms (3Â months) Partial: Reduction of symptoms to a sub-diagnostic level (3Â months) |
Agras et al. [21] | ED | Every 3Â months to 4Â years | EDEa | Absence of ED diagnosis (6Â months) determined by EDEa |
Stice et al. [27] | ED | Every year for 8Â years | Diagnosis | Absence of diagnosis (1Â month) [34] |
Quadflieg et al. [45] | ED | 22Â years (average 11Â years) | Diagnosis | Absence of diagnosis (DSM IV) (3Â months) |
Brown et al. [18] | AN | 0.5 years | %EBWb & EDE & behaviours | > 95% EBWb, no fasting or binge eating/purging within the past month, and EDE-Q global score within 1 SD of adolescent norms [46] |
Wade et al. [47] | AN | 1Â year | Behaviours & EDE-Qd | Absence of eating disorder behaviours (binge eating, purging, driven exercise, and fasting) (3Â months) and normative levels of eating disorder psychopathology (1Â month) determined by EDE-Qd within 1 SD of community norms [48] |
Strandjord et al. [25] | ARFID & AN | 1 year | Diagnosis & %EBWb | > 90% EBW and absence of diagnosis (3 months) |
Le Grange et al. [30] | AN | Every year to 4 years | %EBWb & EDEa | > 95% EBW and EDEa global score within 1 SD of community norms |
Franko et al. [49] | AN, BN | Every 6Â months to 25Â years | Diagnosis | Absence of diagnostic criteria (DSM-5) for a sustained period of time [50] |
Gorrell et al. [31] | BN | Every 6 months to 1 year | Diagnosis, behaviours & EDEa | Model A: Absence from eight compensatory weight control behaviours (DSM-5) that contribute to BN Model B: Model A and EDEa global scores within 1SD of community norms (i.e., < 3.05; Alison, 1996) Model C: Absence from objective and subjective binge eating and self-induced vomiting plus EDEa global scores within 1SD of community norms |
Lydecker et al. [51] | BED | 0.5Â years | Behaviours | Absence of binge-eating episodes for 4 consecutive weeks |
Recovery | ||||
Bardone-Cone et al. [29] | ED | 3 months | Diagnosis, BMI, behaviours & EDE-Qd | Full: Absence of diagnosis (3 months), absence of behaviours (bingeing, purging, or fasting) (3 months), BMI > 18.5, EDE-Qd sub scale scores within 1SD of age-matched community norms Partial: Absence of physical and behavioural symptoms, but persistence of psychological symptoms |
Castellini et al. [7] | ED | Every 3Â years for 6Â years | Diagnosis | Absence of diagnosis (DSM-IV or DSM-V) (3Â years) [32] |
Stice et al. [33] | ED | Every year for 8Â years | Diagnosis | Absence of diagnosis (1Â month) [34] |
Eielsen et al. [52] | ED | 17Â years | EDEa | |
Wild et al. [55] | AN | 1Â year | Diagnosis | Absence of diagnosis (12Â months) |
Zerwas et al. [56] | AN | 1Â year | Diagnosis | Absence of diagnosis (12Â months) |
Ricca et al. [57] | AN, subthreshold-AN | 3Â years | Diagnosis | Absence of diagnosis (DSM-IV) |
Winkler et al. [58] | AN | 12Â years | Diagnosis | Absence of diagnosis (12Â months) |
Rigaud et al. [20] | AN | Yearly for 13 years | BMI, behaviours, psychology | BMI ≥ 18.5, absence of excessive physical exercising, normalised eating, no reported obsessive body shape or weight concerns |
Wentz et al. [59] | AN | 18Â years (at 2, 6, 8, 12, 16Â years) | Diagnosis | Absence of diagnosis (6Â months) |
Castellini et al. [7] | AN, BN (Binge & Purging subtype) | 6Â years | Diagnosis | Absence of diagnosis (DSM-IV) (8Â weeks) |
Franko et al. [49] | AN, BN | Every 6 months for 25 years | PSRe | PSRe ≤ 2 at end of 52 week data collection period [50] |
Castellini et al. [60] | BED & BN | 3Â years | Diagnosis | Absence of diagnosis (DSM-IV) |