Correlates of severity in bulimia nervosa.
OBJECTIVE
We sought to clarify the correlates of severity in women with bulimia nervosa.


METHODS
We studied 114 bulimic women at entry to a randomized clinical trial. We used eight definitions of severity that encompassed the DSM-III-R criteria set for bulimia nervosa (i.e., binging, purging, and body dissatisfaction in the current and worst lifetime time frames) and global functioning and symptomatology. We operationalized 28 possible correlates of severity that covered demographic, Axis I psychiatric, personality, family background, symptoms, and neuropsychological domains. We used regression techniques to investigate the associations between the correlates and severity indices.


RESULTS
The regression models were all statistically significant and tended to account for a sizeable proportion of variance. In particular, earlier age of onset of bulimia and lower character scores (measured by the Temperament and Character Inventory) correlated with greater severity. Worse mean parental care (from the Parental Bonding Instrument), the absence of any lifetime anxiety disorder, and the presence of any lifetime mood disorder emerged as independent correlates in several models.


CONCLUSIONS
As these were hypothesis-generating analyses, confirmation or refutation of these results awaits further study. In particular, age of onset of bulimia and personality traits related to character may be important modifiers of the severity of illness in bulimia nervosa.
University Department of Psychological Medicine, Christchurch School of Medicine, New Zealand.
P F
PF
Sullivan
C M
CM
Bulik
F A
FA
Carter
P R
PR
Joyce
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000437:Alcoholism / Q000150:complications; D001008:Anxiety Disorders / Q000150:complications; D001828:Body Image; D002032:Bulimia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008487:Medical History Taking; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications; D009483:Neuropsychological Tests; D010554:Personality Disorders / Q000150:complications; D010555:Personality Inventory; D012044:Regression Analysis; D012720:Severity of Illness Index