Major Affective Disorder in Anorexia Nervosa and Bulimia

Abstract

DSM-III lifetime diagnoses were assessed in 52 patients with a lifetime history of anorexia nervosa or bulimia by means of a standardised diagnostic interview. It was found that 44.2% had a lifetime diagnosis of DSM-III major affective disorder, with abstaining anorectics having a lower rate of depression than those with bulimic symptoms. In the great majority of cases, the onset of affective disorder post-dated the onset of the eating disorder by at least one year. In patients whose eating disorder was in remission, the rate of depressive symptoms was lower than in those in the acute stage of their illness. These findings, combined with recent studies on biological changes in eating disorders, and psychological theories of depression, suggest that in most cases in which the two conditions are associated, the depression is secondary to the eating disorder.

Bulimia nervosa in two cultures: A comparison of Austrian and American college students

“…In addition, bulimic subjects in both cultures reported similar rates of most DSM-111-R Axis I psychiatric disorders. These rates of associated psychiatric disorders, including mood, anxiety, and impulse-control disorders, are similar to those reported in previous comparable studies from our group and others in the United States (Hudson, Pope, Jonas, & Yurgelun-Todd, 1983b;Walsh, Roose, Glassman, Gladis, & Sadik, 1985;Powers, Coovert, Brightwell, & Stevens, 1988;Keck et al, 1990) and one group in Germany (Laessle, Kittl, Fichter, Wittchen, & Perke, 1987). (We were unable to locate comparable studies in Austria).…”

The co‐morbidity of eating disorders and anxiety disorders: a review

“…The prevalence of anxiety disorders amongst BN samples has been reported in a number of investigations (Bulik et al, 2000;Brewerton et al, 1995;Hudson et al, 1983Hudson et al, , 1987Laessle et al, 1989;Piran et al, 1985;Powers et al, 1988;Schwalberg et al, 1992;Walsh et al, 1985). Similarly, prevalence amongst AN samples has also been investigated (Deep et al, 1995;Halmi et al, 1991;Herpertz-Dahlmann et al, 1996;Laessle et al, 1987) (see Table 1). Lifetime prevalence rates of at least one anxiety disorder varies from 25% (Keck European Eating Disorders Review Eur.…”

“…A number of studies show that social phobia is common in patients with eating disorders (Brewerton et al, 1995;Godart et al, 2000;Halmi et al, 1991;Hinrichson, Wright, Waller, & Meyer, 2003;Iwasaki et al, 2000;Kaye et al, 2004;Laessle et al, 1987Laessle et al, , 1989Lilenfeld et al, 1998;Piran et al, 1985;Powers et al, 1988;Schwalberg et al, 1992) (see Tables 2-4 for a summary of findings). Several studies suggest, that social anxiety may be a more common co-morbid condition with eating disorders than OCD, and some researchers have speculated that social anxiety may play a role in the aetiology of eating disorders (Black Becker et al, 2004).…”

“…The reported lifetime prevalence of specific phobias amongst individuals with eating disorders varies considerably, ranging from 0% (Piran et al, 1985) to 34% (Godart et al, 2000) in AN and from 10% (Schwalberg et al, 1992) to 46% (Laessle et al, 1987) in BN. Follow up studies have reported that there is no difference between AN and controls (Lilenfeld et al, 1998) however, in a community study, the risk for phobia is increased by 2 to 4 in AN subjects (Kendler et al, 1991;Walters and Kendler, 1995) and by 2.37 in BN subjects (Kendler et al, 1991).…”

“…Disorders Rev. 15, 253-274 (2007) (Schwalberg et al, 1992) in BN and from 23% (Laessle et al, 1987) to 75% (Deep et al, 1995) in AN. Several studies have shown that, in most cases, the onset of an anxiety disorder precedes the onset of an eating disorder (Brewerton et al, 1995;Bulik, 2003;Deep et al, 1995;Godart et al, 2003;Schwalberg et al, 1992) (see Table 1 for summary).…”