DSM-IV threshold versus subthreshold bulimia nervosa.
OBJECTIVE
The purpose of the present work is to determine whether bulimia nervosa (BN) and eating disorder not otherwise specified, BN type (EDNOS-BN) were qualitatively distinct in terms of eating and general psychopathology.


METHODS
This study presents a comparison of 138 women with BN and 57 with EDNOS-BN from a multisite study on eating-related and general psychopathology measures.


RESULTS
Although women with BN reported higher lifetime history rates of anorexia nervosa, greater binge eating and vomiting frequency, and more eating concerns, no significant differences were observed between groups on measures of perfectionism, impulsivity, obsessive-compulsiveness, anxiety, depressive symptomatology, or alcohol/substance problems. Based on the partial eta2 values, the distinction between BN and EDNOS-BN accounted for <5% of the criterion variance in general psychopathology measures. Post hoc analyses comparing EDNOS-BN with objective bulimic episodes (OBEs; n=34) versus no OBEs (n=23) found greater EDEQ-4 Restraint subscale scores for EDNOS-BN without OBEs. However, there was no significant difference on the EDEQ-4 Eating Concern subscale between the two EDNOS-BN subgroups.


CONCLUSIONS
The findings highlight the clinical significance of BN partial syndrome and prompt reevaluation of existing BN diagnostic boundaries. Post hoc analyses also underscore the need for greater differentiation within EDNOS.
le Grange
Daniel
D
Department of Psychiatry, The University of Chicago, Chicago, Illinois 60637, USA. legrange@uchcago.edu
Binford
Roslyn B
RB
Peterson
Carol B
CB
Crow
Scott J
SJ
Crosby
Ross D
RD
Klein
Marjorie H
MH
Bardone-Cone
Anna M
AM
Joiner
Thomas E
TE
Mitchell
James E
JE
Wonderlich
Stephen A
SA
D000328:Adult; D052018:Bulimia Nervosa / Q000145:classification*; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D010552:Personality Assessment; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires