The genuine prevalence of personality disorders among those with eating disorders is unknown. However, in this paper, we summarize the existing data, with careful acknowledgment of our approach to interpretation as well as the limitations of previous studies. Our findings indicate that obsessive-compulsive personality is the most common personality disorder in restricting-type anorexia nervosa, while borderline personality is the most common personality disorder in binge-eating/purging type anorexia nervosa. Borderline personality is the most common personality disorder in bulimia nervosa, as well. In those with binge eating disorder, obsessive-compulsive personality is the most common personality disorder although, compared with the preceding eating disorder diagnoses, there are broader clusters of personality disorders represented in this group. We discuss the implications of these findings.

Large epidemiological studies on the prevalence of self-harm behavior among those with eating disorders are not currently available. Using the Medline and PsycINFO databases, the authors collectively summarize data from available studies. The largest group of studies reports the prevalence of suicide attempts among outpatients with bulimia nervosa to be 23% (n = 1211). The prevalence of suicide attempts among bulimic inpatients was 39% (n = 260), alcoholic bulimics 54% (n = 76), and outpatient anorexics 16% (n = 261). Self-injury among bulimic outpatients was 25% (n = 574), inpatient bulimics 25% (n = 260), and outpatient anorexics 23% (n = 52). The authors discuss the possible implications of these findings.

Borderline personality disorder (BPD) is an Axis II disorder that is characterized by an intact façade, longstanding self-regulation difficulties and self-harm behavior, and unstable interpersonal relationships and mood. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994), the prevalence of BPD in the general population is around 2%. The symptoms of the disorder appear to be influenced by gender. Despite defined diagnostic criteria, BPD tends to have polymorphic clinical presentations with both multiple psychological and somatic symptoms. The etiology of BPD appears to be related to genetic predisposition, early developmental trauma, and biparental failure, although other contributory factors may be involved. We discuss, through the use of several models, the possible relationships between BPD and eating disorders.