Comorbid psychopathology in binge eating disorder: Relation to eating disorder severity at baseline and following treatment.

Abstract

Individuals with binge eating disorder (BED) have high rates of comorbid psychopathology, yet little is known about the relation of comorbidity to eating disorder features or response to treatment. These issues were examined among 162 BED patients participating in a psychotherapy trial. Axis I psychopathology was not significantly related to baseline eating disorder severity, as measured by the Structured Clinical Interview for DSM-III-R (SCID-I and SCID-II) and the Eating Disorder Examination. However, presence of Axis II psychopathology was significantly related to more severe binge eating and eating disorder psychopathology at baseline. Although overall presence of Axis II psychopathology did not predict treatment outcome, presence of Cluster B personality disorders predicted significantly higher levels of binge eating at 1 year following treatment. Results suggest the need to consider Cluster B disorders when designing treatments for BED.

Binge eating disorder in extreme obesity

“…In common with other studies, 10,17 we found that BED and NBE subjects did not differ on either the EDE Restraint or TFEQ Cognitive Restraint subscales. Perhaps BED in extreme obesity is more a result of greater disinhibition, while the extreme obesity in both groups may be related to relatively low 'restraint'.…”

The relationship among binge severity, personality psychopathology, and body mass index

“…A recent study using the SCID-II with BED individuals found that Cluster B personality disorders predicted higher levels of binge eating at 1 year posttreatment (Wilfley et al, 2000). A study by Eldredge, Locke, and Horowitz (1998) found that among a sample of individuals with BED, poor treatment outcome was associated with distress over problems with social avoidance.…”

“…Axis II psychopathology was determined on a continuum of symptomatology (summation of threshold and subthreshold symptoms) for the current study, based on the finding that the use of a continuous symptom measure is most likely to be associated with the severity of eating disorders (Wilfley et al, 2000).…”

“…This study was unique in that personality disorders were also treated as a continuous variable rather than exclusively as diagnostic categories, based on the suggestion that the use of categorical disorders may be inadequate to capture the relationship between comorbid psychopathology and eating disturbances (Wilfley et al, 2000). A continuum of personality symptoms provided a useful way of collecting information that might have been otherwise missed in a nonclinical sample and provided a more detailed picture of the overall personality pathology of a population about which there is limited current knowledge.…”

“…Findings have indicated that obese individuals who regularly binge exhibit more weight-related and general psychopathology than nonbinging obese individuals Kolotkin, Revis, Kirkley, & Janick, 1987;Marcus et al, 1990;Skodol et al, 1993;Spitzer et al, 1993;StriegelMoore, Wilson, Wilfley, Elder, & Brownell, 1998;Telch & Agras, 1994;Telch & Stice, 1998;Wadden, Foster, Letizia, & Wilk, 1993;Wilfley et al, 2000;Yanovski, Nelson, Dubbert, & Spitzer, 1993). In addition, they consume more calories than nonbinging obese women in a controlled setting (Goldfein, Walsh, LaChaussee, Kissileff, & Devlin, 1993;Yanovski et al, 1992).…”