title: The significance of a history of childhood sexual abuse in bulimia nervosa.
abstract: BACKGROUND
  Childhood sexual abuse (CSA) is found to have occurred to a substantial minority of women with bulimia nervosa. Its clinical significance is unclear.
  
  
  METHODS
  We studied 87 bulimic women in a clinical trial. Structured interviews determined the presence of CSA, DSM-III-R disorders, global functioning, and depressive and bulimic symptoms.
  
  
  RESULTS
  Forty-four per cent reported a history of CSA. Bulimic women with CSA reported earlier onset of bulimia, greater depressive symptoms, worse global functioning and more suicide attempts, and were more likely to meet criteria for bipolar II disorder, alcohol and drug dependence, conduct disorder and avoidant personality disorder.
  
  
  CONCLUSIONS
  Although those with CSA had greater comorbidity, it was not an important modifier of bulimic symptoms.
authors.affiliation: University Department of Psychological Medicine, Christchurch School of Medicine, New Zealand.
authors.forename: P F
authors.initials: PF
authors.lastname: Sullivan
authors.forename: C M
authors.initials: CM
authors.lastname: Bulik
authors.forename: F A
authors.initials: FA
authors.lastname: Carter
authors.forename: P R
authors.initials: PR
authors.lastname: Joyce
mesh_terms: D000293:Adolescent; D000328:Adult; D002032:Bulimia / Q000523:psychology*; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D002675:Child, Preschool; D003866:Depressive Disorder / Q000523:psychology; D005260:Female; D006801:Humans; D007179:Incest / Q000523:psychology; D010552:Personality Assessment; D010553:Personality Development; D012307:Risk Factors