The significance of a history of childhood sexual abuse in bulimia nervosa.
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.
Sullivan
P F
PF
University Department of Psychological Medicine, Christchurch School of Medicine, New Zealand.
Bulik
C M
CM
Carter
F A
FA
Joyce
P R
PR
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