Do adolescents with eating disorder not otherwise specified or full-syndrome bulimia nervosa differ in clinical severity, comorbidity, risk factors, treatment outcome or cost?
OBJECTIVE
We wanted to know whether adolescents with eating disorder not otherwise specified (EDNOS) differ from those with bulimia nervosa (BN) in clinical features, comorbidity, risk factors, treatment outcome or cost.


METHODS
Adolescents with EDNOS (n = 24) or BN (n = 61) took part in a trial of family therapy versus guided self-care. At baseline, eating disorder symptoms, risk factors, and costs were assessed by interview. Patients were reinterviewed at 6 and 12 months.


RESULTS
Compared with EDNOS, BN patients binged, vomited and purged significantly more, and were more preoccupied with food. Those with EDNOS had more depression and had more current and childhood obsessive-compulsive disorder. 66.6% of EDNOS versus 27.8% of BN patients were abstinent from bingeing and vomiting at 1 year. Diagnosis did not moderate treatment outcome. Costs did not differ between groups.


CONCLUSIONS
EDNOS in adolescents is not trivial. It has milder eating disorder symptoms but more comorbidity than BN.
Schmidt
Ulrike
U
Section of Eating Disorders, Institute of Psychiatry, King's College, London, United Kingdom. u.schmidt@iop.kcl.ac.uk
Lee
Sally
S
Perkins
Sarah
S
Eisler
Ivan
I
Treasure
Janet
J
Beecham
Jeny
J
Berelowitz
Mark
M
Dodge
Liz
L
Frost
Susie
S
Jenkins
Mari
M
Johnson-Sabine
Eric
E
Keville
Saskia
S
Murphy
Rebecca
R
Robinson
Paul
P
Winn
Suzanne
S
Yi
Irene
I
D000293:Adolescent; D000328:Adult; D052018:Bulimia Nervosa / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D015897:Comorbidity; D003365:Costs and Cost Analysis; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012648:Self Care; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome