The prevalence of DSM-IV personality pathology among individuals with bulimia nervosa, binge eating disorder and obesity.
BACKGROUND
There are numerous reports of personality disorder pathology in different eating disorders. However, few studies have directly compared personality pathology in bulimia nervosa, binge eating disorder and obesity. The present study examines group differences in DSM-IV personality pathology, considering the potential utility of understanding personality disorders in terms of diagnosis and dimensional scores.


METHODS
Eating disorder diagnoses were established using the Eating Disorder Examination interview. Thirty-five bulimia nervosa patients, 15 binge eating disorder patients and 37 obese patients were assessed and compared on the International Personality Disorder Examination using categorical and dimensional personality disorder scores.


RESULTS
For most personality disorders, there was a dichotomy of binge eaters versus non-binge eaters. In contrast, there was a continuum of severity in borderline personality disorder pathology between the groups. The dimensional system of measurement of personality pathology allowed for clearer differentiation between the groups.


CONCLUSIONS
The study strongly indicates that personality disorder difficulties are present in patients who binge eat, while obese patients who do not binge eat display significantly less personality disorder pathology. Assessment of bulimia nervosa, binge eating disorder and obesity needs to address personality disorders and pathology. Dimensional markers of personality pathology can be used to supplement categorical diagnoses, providing information about the traits that underlie diagnosis.
van Hanswijck de Jonge
P
P
Department of Psychiatry, St George's Hospital Medical School, University of London, Cranmer Terrace.
Van Furth
E F
EF
Lacey
J Hubert
JH
Waller
G
G
D000328:Adult; D015992:Body Mass Index; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002032:Bulimia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D010552:Personality Assessment / Q000706:statistics & numerical data; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011594:Psychometrics / Q000706:statistics & numerical data