Eating disorders in a large clinical sample of men and women with personality disorders

Authors

  • Deborah L. Reas PhD,

    Corresponding author
    1. Regional Eating Disorders Service, Division of Mental Health and Addiction, Oslo University Hospital, Norway
    • Correspondence to: Deborah Lynn Reas, PhD, Regional Eating Disorders Service (RASP), Division of Mental Health and Addiction, Oslo University Hospital-Ullevål, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway. E-mail: deborah.lynn.reas@ous-hf.no

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  • Øyvind Rø MD, PhD,

    1. Regional Eating Disorders Service, Division of Mental Health and Addiction, Oslo University Hospital, Norway
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  • Sigmund Karterud MD, PhD,

    1. Institute for Clinical Medicine, University of Oslo, Oslo, Norway
    2. Division of Mental Health and Addiction, Department of Research and Development, Oslo University Hospital, Oslo, Norway
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  • Benjamin Hummelen MD, PhD,

    1. Division of Mental Health and Addiction, Department of Research and Development, Oslo University Hospital, Oslo, Norway
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  • Geir Pedersen PhD

    1. Division of Mental Health and Addiction, Department of Personality Psychiatry, Oslo University Hospital, Oslo, Norway
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ABSTRACT

Objective

We assessed and compared the prevalence of anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS) across six Axis II groups (borderline, obsessive-compulsive, avoidant, dependent, paranoid, and personality disorder NOS) and patients with major depressive disorder (MDD) without personality disorders (PD).

Method

The sample included 3,266 consecutive and first admissions to 16 different treatment units in the Norwegian Network of Psychotherapeutic Day Hospitals between 1993 and 2009. All patients were interviewed with the SCID-II for DSM-III-R (prior to 1996) or DSM-IV (from 1996) and the MINI for Axis I disorders in accordance with the LEAD (longitudinal, expert, all-data) standard.

Results

The prevalence of any ED in the PD sample was approximately 17% for women and 3% for men. A lower rate of ED (5%) was found for patients with MDD without PD. A significantly higher proportion of patients with borderline personality disorder were diagnosed with BN or EDNOS. The rate of AN was significantly elevated in female patients with obsessive-compulsive personality disorder. Men demonstrated significantly less diagnostic co-occurrence and no significant differential variation across PD groups or MDD.

Discussion

Data which included a psychiatric comparison group showed less co-occurrence and non-significant variation across PD groups for men, but demonstrated a meaningful and specific pattern of comorbidity between ED and PD for women. There was an elevated risk of ED among female patients with PD, most pronounced for borderline. An almost five-fold higher rate of AN was found among women with obsessive-compulsive PD. © 2013 Wiley Periodicals, Inc.(Int J Eat Disord 2013; 46:801–809)

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