Bulimia nervosa. Four uncommon subtypes.
The histories and psychological profiles of more than 500 patients meeting DSM-III-R criteria for bulimia nervosa were reviewed. A total of 310 patients demonstrated the most characteristic pattern of bulimia, with finger-induced purging and occasional diet pill, diuretic, or laxative abuse. Seventeen patients reported binge eating with no self-induced vomiting but with severe laxative abuse (i.e., greater than or equal to 50 laxatives daily). A total of 126 patients reported bulimia with finger-induced purging and regular mild (i.e., 2-3 daily) laxative abuse. Eight patients reported bulimia without finger-induced purging, diuretic, or laxative abuse but with the regular abuse of ipecac as a means of inducing vomiting. Four clinical subtypes of bulimia were seen. These were overt bulimia, which occurred in 8.9% of the sample; obsessive-ritualistic bulimia, which occurred in 2% of the sample; sexually evocative bulimia (Fatal Attraction Syndrome), which occurred in 2.9% of the sample; and masochistic bulimia, which occurred in 4.9% of the sample. Each of these subtypes of bulimia are described and defined. The characteristic psychologic profile, clinical features, and implications for treatment and research are discussed.
Hall
R C
RC
University of Florida, Gainesville.
Blakey
R E
RE
Hall
A K
AK
D000184:Acting Out; D000293:Adolescent; D000328:Adult; D000368:Aged; D002032:Bulimia / Q000145:classification* / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D002648:Child; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008950:MMPI; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D010552:Personality Assessment; D010554:Personality Disorders / Q000150:complications / Q000523:psychology; D011569:Psychiatric Status Rating Scales