Anorexia nervosa patients with a prior history of bulimia nervosa.
OBJECTIVE
To investigate clinical and psychological features of patients with anorexia nervosa (AN) with a previous history of bulimia nervosa.


METHODS
Three hundred thirty-three patients with a full diagnosis of AN were assessed by the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the Eating Disorders Inventory, and the Hopkins Symptom Checklist.


RESULTS
Twenty-four patients (7%) reported a previous diagnosis of bulimia nervosa and were compared with a control group of 48 patients without a history of bulimia, matched for diagnostic subtype. Among the patients with a history of bulimia nervosa, 11 were of the restricting type and 13 of the binge eating/purging type. Among restricting anorexic patients, those with a history of bulimia reported greater age of onset, more psychiatric symptoms, more family psychiatric morbidity, and a higher rate of sexual abuse. On the contrary, among patients with the AN bingeing-purging subtype, the presence of a previous bulimia nervosa was not associated with any of the investigated variables.


CONCLUSIONS
Patients with restricting AN who report a history of previous bulimia nervosa are not frequent among those referring to an outpatient eating disorders unit. However, our findings in this small group of subjects confirm that a lifetime history of bingeing and purging in patients with eating disorder, irrespective of when it occurs, is always associated with more psychopathology compared with those restricting patients with AN who have never had a period of bingeing and purging.
Santonastaso
Paolo
P
Clinica Psichiatrica, Dipartimento di Neuroscienze, Università di Padova, 35128 Padova, Italy.
Zanetti
Tatiana
T
De Antoni
Chiara
C
Tenconi
Elena
E
Favaro
Angela
A
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015992:Body Mass Index; D001835:Body Weight; D052018:Bulimia Nervosa / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D013223:Statistics as Topic