Impulse control disorders in women with eating disorders.
We compared symptom patterns, severity of illness, and comorbidity in individuals with eating disorders with and without impulse control disorders (ICD), and documented the temporal pattern of illness onset. Lifetime ICD were present in 16.6% of 709 women with a history of eating disorders. The most common syndromes were compulsive buying disorder and kleptomania. ICD occurred more in individuals with binge eating subtypes, and were associated with significantly greater use of laxatives, diuretics, appetite suppressants and fasting, and with greater body image disturbance, higher harm avoidance, neuroticism, cognitive impulsivity, and lower self-directedness. In addition, individuals with ICD were more likely to have obsessive-compulsive disorder, any anxiety disorder, specific phobia, depression, cluster B personality disorder, avoidant personality disorder, and to use psychoactive substances. Among those with ICD, 62% reported the ICD predated the eating disorder and 45% reported the onset of both disorders within the same 3-year window. The presence of a lifetime ICD appears to be limited to eating disorders marked by binge eating and to be associated with worse eating-related psychopathology, more pathological personality traits, and more frequent comorbid Axis I and II conditions. Untreated ICD may complicate recovery from eating disorders.
Fernández-Aranda
Fernando
F
Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.
Pinheiro
Andréa Poyastro
AP
Thornton
Laura M
LM
Berrettini
Wade H
WH
Crow
Scott
S
Fichter
Manfred M
MM
Halmi
Katherine A
KA
Kaplan
Allan S
AS
Keel
Pamela
P
Mitchell
James
J
Rotondo
Alessandro
A
Strober
Michael
M
Woodside
D Blake
DB
Kaye
Walter H
WH
Bulik
Cynthia M
CM
D000328:Adult; D000368:Aged; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000453:epidemiology*; D001068:Feeding and Eating Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015995:Prevalence