Psychiatric comorbidity of bulimia nervosa inpatients: relationship to clinical variables and treatment outcome

Abstract

SummaryExperimental evidence suggesting that psychiatric comorbidity has important clinical and prognostic implications in bulimia nervosa has mostly been based on outpatient studies investigating a selection of co-existing psychopathological features with rather unstructured and not standardized diagnostic instruments. Using structured instruments (SCID-P, MDCL) for the diagnoses of DSM III-R axis I disorders and clinical interviews for the diagnosis of DSM III-R axis II disorders in 24 hospitalized bulimics, the present study demonstrated that more than half of the patients had two or three axis I disorders in addition to bulimia nervosa and almost half of the patients met criteria of at least one personality disorder. Subgroups of patients classified according to the type of psychiatric comorbidity did not differ significantly with respect to clinical features; regarding measures of hospital behavior therapy outcome. However, the findings provided evidence for a negative impact of anxiety disorder in addition to bulimia nervosa on the improvement of bulimic behavior and possibly also on self-rated depression.