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The objective of this study was to analyze clinical and personality differences in three groups of patients with eating disorders: binge eating disorder (BED), bulimia nervosa- purging type (BN-P) and bulimia nervosa-non purging type (BN-NP).
The participants were 102 female patients (34 BED, 34 BN-P and 34 BN-NP), mean age 28.7. Assessment measures included the following tests: EDI-2, BITE, EAT-40, SCL-90-R and TCI-R, and other clinical and psychopathological indices that were collected via semi-structured interview.
When compared all three groups, BED were the oldest group, showed more frequent familial history of obesity and current or lifetime obesity. Regarding psychopathology, BN-P patients showed the most pathological scores, followed by BN-NP patients and BED patients showing the least pathological scores. Specifically, BN-P patients showed statistically higher scores than BED patients on SCL-90-R Paranoid Ideation, EAT-40 total score, EDI-2 Impulsivity subscale, and BITE Severity subscale. No statistically significant differences were observed among groups, on personality traits. A two-step cluster analysis procedure was conducted, to determine the clinical proximity among the three diagnostic groups. The relationship between cluster classification and diagnosis was statistically different (p<0.001), so we can assume that the present classification maybe does not classify accurately eating disorders.
Even when BED patients present differential characteristics with respect to family and personal antecedents when compared to BN patients, clinical and psychopathological overlapping with BN-NP makes them similar. Likewise, our results suggest deficiencies in the current nosological system, since it does not group patients’ subgroups which are homogeneous enough.
Given the clinical similarity and the frequent comorbidity between impulse control disorders and certain eating disorders (ED) such as bulimia nervosa, we aimed to compare personality and clinical profiles of individuals with and without substance use disorders (SUD) who had primary diagnoses of ED or impulse control disorders, namely pathological gambling (PG).
1096 ED [91.8% females] and 1120 PG [92.4% males] patients were assessed for the presence of SUD. All patients were consecutively admitted to our Psychiatry Department and diagnosed according to DSM-IV-TR criteria. We administered the Temperament and Character Inventory-Revised (TCI-R), the Symptom ChekList-90-Revised (SCL-90-R), and other clinical indices. Lifetime substance use included alcohol and other substances and was measured with the SCID-I. Student-Fisher t-tests were used to compare clinical features. Binary logistic regression models were used to analyse personality predictors of comorbidity with SUD. Adjustments for sex, age, and specific diagnosis were applied.
High Novelty Seeking, low Reward Dependence and low Self-Directedness were predictive of SUD in the whole sample independent of diagnosis (p<0.01). In the PG sample only, after adjustment for sex and age, Reward Dependence was no longer associated with SUD. Patients of both clinical samples with SUD showed higher SCL-90-R scores and severer eating and gambling symptoms (respectively).
Our results suggest that high Novelty Seeking, low Reward Dependence and low Self-Directedness are associated with lifetime SUD, which is also associated with a severer presentation of the primary disorder. This pattern holds across different populations such as ED and PG.
The objective of this study was to examine the experience and expression of anger in eating disorders (EDs) including bulimia nervosa purging (BN-P) and anorexia nervosa restrictive (AN-R) subtypes, impulsive disorders such as pathological gambling (PG), obsessive-compulsive disorder (OCD) and a non psychiatric healthy control group.
The sample comprised 80 female SODs individuals (20 BN-P, 21 AN-R, 19 PG, 21 TOC) consecutively admitted to our Department and 21 healthy controls. Patients were diagnosed according to DSM-IV-R criteria. We administered the State-Trait Anger Expression Inventory-2 (STAXI-2). in the control group, the GHQ-28 was also employed.
Compared to the healthy control group, elevated Trait Anger scores were revealed for the BN-P (p< .011) and OCD (p< .003) groups. in addition, the OCD group scored higher on this scale than the PG patients (p< .039). as regards to State Anger, higher scores were uncovered for the OCD patients than for the control group (p< .017). Finally, when Anger Expression was assessed, higher scores were found for the OCD (p< .001) and BN (p< .001) individuals when compared to healthy controls. in addition, compared to AN-R, the BN-P and OCD exhibited higher scores on this scale (p< .001 and p< .037, respectively).
Our results indicate that, OCD and BN-P patients may have inadequate anger expressions and deficits in coping with anger and frustration when compared to a healthy control group. Conversely, no significant differences were revealed between AN-R, PG and controls. Finally, some differences across diagnoses were also obtained.
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