Bulimia nervosa with history of anorexia nervosa: Could the clinical subtype of anorexia have implications for clinical status and treatment response?

Authors

  • Francisco J. Vaz-Leal MD, PhD,

    Corresponding author
    1. Department of Psychiatry, Faculty of Medicine, University of Extremadura, Badajoz, Spain
    2. Mental Health Unit and Eating Disorders Unit, University Hospital Network, Extremadura Health Services, Badajoz, Spain
    • Departamento de Psiquiatría, Facultad de Medicina, Avda de Elvas s/n (Campus Universitario), Badajoz 06071, Spain
    Search for more papers by this author
  • Laura Rodríguez Santos PhD,

    1. Department of Psychiatry, Faculty of Medicine, University of Extremadura, Badajoz, Spain
    Search for more papers by this author
  • M. Angustias García-Herráiz MD, PhD,

    1. Mental Health Unit and Eating Disorders Unit, University Hospital Network, Extremadura Health Services, Badajoz, Spain
    Search for more papers by this author
  • Melchora Monge-Bautista PhD,

    1. Mental Health Unit and Eating Disorders Unit, University Hospital Network, Extremadura Health Services, Badajoz, Spain
    Search for more papers by this author
  • Beatriz López-Vinuesa PhD

    1. Department of Psychiatry, Faculty of Medicine, University of Extremadura, Badajoz, Spain
    2. Mental Health Unit and Eating Disorders Unit, University Hospital Network, Extremadura Health Services, Badajoz, Spain
    Search for more papers by this author

  • Supported by PI060974 from Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica [I+D+I]; Fondo de Investigación Sanitaria; Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Spain; and European Social Fund.

Abstract

Objective:

To investigate whether the subtype of anorexia nervosa (AN) could influence the bulimic syndrome and treatment response in bulimia nervosa (BN) patients with a history of AN (BN/AN+).

Method:

Seventy female BN patients were assessed for eating disorder, psychopathology and personality, and treated for 6 months.

Results:

BN/AN+ patients retained some traits of their past condition: lower body weight, higher perfectionism, and higher reward dependence. They also had more severe symptoms, longer evolution time, and worse response to treatment. A history of restricting AN was associated to higher age, longer evolution time, higher impulsivity, and greater tendency to use diet pills and diuretics. A history of binge-purging AN was associated to more severe vomiting, lower body dissatisfaction and less depressive symptoms, as well as better outcome.

Discussion:

The influence of the AN subtype in BN/AN+ patients is worthy of further study as it might have clinical implications. © 2010 by Wiley Periodicals, Inc (Int J Eat Disord 2011; 44:212–219)

Ancillary