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Setting the scene for eating disorders: childhood care, classification and course of illness

Published online by Cambridge University Press:  09 July 2009

Ulrike Schmidt ,
Jane Tiller  and
Janet Treasure
Ulrike Schmidt*
Affiliation:
Institute of Psychiatry, London
Jane Tiller
Affiliation:
Institute of Psychiatry, London
Janet Treasure
Affiliation:
Institute of Psychiatry, London
*
1Address for correspondence: Dr Ulrike Schmidt, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
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Synopsis

The aim of this study was to determine whether the childhood experiences of patients with anorexia nervosa and bulimia nervosa differ and affect the course of the illness. A semistructured interview developed by Harris et al. (1986) was used to assess the childhood family environment of 64 patients with restricting anorexia nervosa (RAN), 23 patients with bulimic anorexia nervosa (BAN), 37 bulimic patients with a history of anorexia nervosa (BN/HistAN) and 79 patients with normal weight bulimia nervosa (BN).

There were no significant differences between groups in terms of parental mental disorder, low parental control or childhood sexual abuse. BN patients had had significantly more family arrangements and had experienced more parental indifference, excessive parental control, physical abuse, and violence against other family members than RAN patients with the BAN and BN/HistAN group being intermediate. There was a trend for BN-patients to have had more intra-familial discord than the other groups. Different aspects of adversity tended to cluster in the same patients and 65% of the bulimic group had experienced two or more types of childhood adversity. These results suggest that childhood experiences contribute to the form of eating disorder which later develops.

Type
Original Articles
Information
Psychological Medicine , Volume 23 , Issue 3 , August 1993 , pp. 663 - 672
Copyright
Copyright © Cambridge University Press 1993

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