The validity and clinical utility of purging disorder

Keel, Pamela K.; Striegel‐Moore, Ruth H.

doi:10.1002/eat.20718

Cited by 96 publications

(100 citation statements)

References 55 publications

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“…Although PD comorbidity occurs less frequently in BED and EDNOS than in AN and BN, the severity or impact on treatment may be of comparable concern when present. Moreover, the variance in the proportions of any PD was considerably wider for EDNOS than for BED, hence supporting the notion of EDNOS as a clinically more heterogeneous diagnosis than BED (Agras et al, 2009;Keel and Striegel-Moore, 2009;Milos et al, 2005). This implies that some patients with EDNOS may have more comorbidity conditions than patients with BED.…”

Section: Overall and Cluster Level Comparisonsmentioning

confidence: 60%

“…In a meta-analysis, the general level of psychopathology was comparable for EDNOS and AN, although patients with BN reported somewhat higher levels of pathology (mean d = 0.19) than patients with EDNOS (Thomas et al, 2009). Some subtypes of EDNOS, particularly the purging one, may show a wider spectrum of clinical severity than that of AN and BN (Keel and Striegel-Moore, 2009). EDNOS can be a transitional stage to recovery (Agras et al, 2009), as well as to AN or BN (Milos et al, 2005).…”

mentioning

confidence: 90%

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Personality Disorders in Eating Disorder Not Otherwise Specified and Binge Eating Disorder

Friborg

Martinussen

Kaiser

et al. 2014

Journal of Nervous &Amp; Mental Disease

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A meta-analysis was conducted to identify the proportion of comorbid personality disorders (PDs) in patients with eating disorder not otherwise specified (EDNOS) and binge eating disorder (BED). A search identified 20 articles in the period of 1987 to 2010. For EDNOS and BED, the comorbid proportions for any PD were 0.38 and 0.29, respectively; for cluster C PDs, 0.38 and 0.30, respectively (avoidant PD, 0.18 and 0.12, and obsessive-compulsive PD, 0.11 and 0.10, respectively); and for cluster B PDs, 0.25 and 0.11, respectively (borderline, 0.12 and 0.10). This pattern converged with findings on anorexia nervosa and bulimia nervosa, except being lower. Because the comorbidity profiles for EDNOS and BED were highly similar, their underlying PD pathology seems similar. Few moderators were significant, except for interviews yielding lower estimates than that of questionnaires. The variance statistic for any PD comorbidity was wide for EDNOS and narrow for BED, thus partly supporting BED as a distinct eating disorder category and EDNOS as a potentially more severe condition than BED.

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Section: Overall and Cluster Level Comparisonsmentioning

confidence: 60%

mentioning

confidence: 90%

Personality Disorders in Eating Disorder Not Otherwise Specified and Binge Eating Disorder

Friborg

Martinussen

Kaiser

et al. 2014

Journal of Nervous &Amp; Mental Disease

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“…Thus, increased SBE frequency may be associated with greater personality disturbance and could be examined for their association with treatment outcomes. 20 Although SBEs have not been reliably included in research definitions of PD, 21 associations with these personality traits implies that SBEs may be clinically relevant.…”

Section: Discussionmentioning

confidence: 99%

Personality pathology in purging disorder and bulimia nervosa

Brown

Haedt‐Matt

Keel

2011

Int. J. Eat. Disord.

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Objective: To compare levels of personality pathology in women with purging disorder (PD), bulimia nervosa (BN), and controls and to compare women with PD and BN on associations between personality pathology and shared eating disorder features.Method: Women with BN (n 5 73), PD (n 5 48), and controls (n 5 64) completed interviews and self-report questionnaires.Results: BN and PD were associated with significantly greater personality pathology compared to controls. Cluster C symptoms and trait anxiety were greater in BN compared to PD, but groups did not differ on Cluster B symptoms or impulsivity. Subjective binge episodes were associated with anxious and impulsive personality traits in PD but not BN. Purging in PD was associated with trait anxiety, while purging in BN was associated with impulsivity.Discussion: Although BN and PD share eating disorder features and personality disturbance, some of the underlying associations between these eating disorder and personality features differ between groups. V V C 2011 by Wiley Periodicals, Inc.

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“…EDNOS-P (also called purging disorder) affects approximately 1% of women and is marked by the presence of compensatory behaviors in the absence of binge episodes. [36][37][38][39] Eating disorders during pregnancy and postpartum For many reasons, women with a lifetime ED history face unique challenges throughout pregnancy and the postpartum period. 5,[11][12][13]15,40 Although some women experience remission during pregnancy, 11 others report that pregnancy exacerbates ED symptoms and can lead to greater dietary restraint, poor nutrition, and increased purging behavior.…”

Section: Introductionmentioning

confidence: 99%

Eating Disorders and Trauma History in Women with Perinatal Depression

Meltzer‐Brody

Zerwas

Leserman

et al. 2011

Journal of Women's Health

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Objective: Although the prevalence of perinatal depression (depression occurring during pregnancy and postpartum) is 10%, little is known about psychiatric comorbidity in these women. We examined the prevalence of comorbid eating disorders (ED) and trauma history in women with perinatal depression. Methods: A research questionnaire was administered to 158 consecutive patients seen in a perinatal psychiatry clinic during pregnancy (n = 99) or postpartum (n = 59). Measures included Structured Clinical Interview for DSM (SCID) IV-based questions for lifetime eating psychopathology and assessments of comorbid psychiatric illness including the State/Trait Anxiety Inventory (STAI), Patient Health Questionnaire (PHQ-9), Edinburgh Postnatal Depression Scale (EPDS), and Trauma Inventory. Results: In this cohort, 37.1% reported a putative lifetime ED history; 10.1% reported anorexia nervosa (AN), 10.1% reported bulimia nervosa (BN), 10.1% reported ED not otherwise specified-purging subtype (EDNOS-P), and 7.0% reported binge eating disorder (BED). Women with BN reported more severe depression (EPDS score, 19.1, standard deviation [SD 4.3], p = 0.02; PHQ-severity 14.5, SD 7.4, p = 0.02) than the referent group of women with perinatal depression and no ED history (EPDS 13.3, SD = 6.1; PHQ 9.0, SD = 6.2). Women with AN were more likely to report sexual trauma history than the referent group (62.5% vs. 29.3%, p < 0.05), and those with BN were more likely report physical (50.0%, p < 0.05) and sexual (66.7%, p < 0.05) trauma histories. Conclusions: ED histories were present in over one third of admissions to a perinatal psychiatry clinic. Women with BN reported more severe depression and histories of physical and sexual trauma. Screening for histories of eating psychopathology is important in women with perinatal depression.

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The validity and clinical utility of purging disorder

Abstract: We discuss strengths and weaknesses associated with various options for the status of Purging Disorder in the DSM-V ranging from making no changes from DSM-IV to designating Purging Disorder a diagnosis on equal footing with Anorexia Nervosa and Bulimia Nervosa.

Cited by 96 publications

References 55 publications

Personality Disorders in Eating Disorder Not Otherwise Specified and Binge Eating Disorder

Personality Disorders in Eating Disorder Not Otherwise Specified and Binge Eating Disorder

Personality pathology in purging disorder and bulimia nervosa

Eating Disorders and Trauma History in Women with Perinatal Depression

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