Are there subgroups of bulimia nervosa based on comorbid psychiatric disorders?

Authors

  • Alexis E. Duncan MPH,

    1. Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
    2. Department of Community Health, St. Louis University School of Public Health, St. Louis, Missouri
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  • Rosalind J. Neuman PhD,

    1. Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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  • John Kramer PhD,

    1. Department of Psychiatry, University of Iowa College of Medicine, Iowa City, Iowa
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  • Samuel Kuperman MD,

    1. Department of Psychiatry, University of Iowa College of Medicine, Iowa City, Iowa
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  • Victor Hesselbrock PhD,

    1. Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut
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  • Theodore Reich MD,

    1. Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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  • Kathleen K. Bucholz PhD

    Corresponding author
    1. Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
    2. Department of Community Health, St. Louis University School of Public Health, St. Louis, Missouri
    • Department of Psychiatry, Washington University School of Medicine, 40 N. Kingshighway, Suite 2, St. Louis, MO 63108
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Abstract

Objective

The current study sought to determine whether there are subtypes of bulimia nervosa (BN) differentiated by comorbid psychiatric disorders.

Method

Data on comorbid psychiatric diagnoses in female relatives of probands and controls in the Collaborative Study of the Genetics of Alcoholism (COGA) who met criteria for BN (as outlined in the 3rd Rev. ed. of the Diagnostic and Statistical Manual of Mental Disorders) were analyzed using latent class analysis. Resulting latent classes were compared on a variety of variables related to impulsive behaviors and psychological functioning.

Results

The best-fitting solution, a two-class model, yielded one class (72%) characterized by substance dependence, depression, antisocial personality disorder (ASPD), and anxiety disorders, and another characterized by depression. The highly comorbid class had more suicidality, more daily smokers, sought help for emotional problems, and had lower Global Assessment of Functioning (GAF) scores compared with those in the comorbid depression only class.

Discussion

Latent class findings suggest the existence of two classes of BN differentiated by substance dependence, impulsive behaviors, and poorer psychological functioning. © 2004 by Wiley Periodicals, Inc.

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