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Binge/purge symptoms and comorbidity in adolescents with eating disorders.
Can J Psychiatry. 1998 Jun; 43(5):507-12.CJ

Abstract

OBJECTIVE

To identify the diagnostic subtypes of eating disorders (EDs), the psychiatric comorbid diagnoses, and associated specific and nonspecific psychopathology in a series of 120 adolescents undergoing standardized assessment for an ED.

METHOD

Consecutive patients referred to our large pediatric hospital for ED assessment completed a semistructured diagnostic interview for children and adolescents. The following self-report scales were administered to assess specific and nonspecific psychopathology: the Children's Depression Inventory (CDI), the Brief Symptom Inventory (BSI), the Eating Disorder Inventory 2 (EDI-2), and the Family Assessment Measure (FAM-III) of family functioning.

RESULTS

Female subjects with a mean age of 14.5 years and a mean body mass index (BMI) of 18.1 comprised 93% of the sample. The restrictive subtypes of anorexia nervosa (AN) (43%) and eating disorder not otherwise specified (EDNOS) (16%) were the most common diagnoses. Patients with restricting symptoms (R) could be grouped together because they were more similar to each other with respect to self-report symptoms of psychopathology than they were to patients with binge/purge (B/P) symptoms and vice versa. Patients with R endorsed significantly fewer subjective symptoms, both ED-specific and nonspecific, and rated their families functioning better than did B/P patients. Comorbid, current major depressive disorders and dysthymic disorders occurred in 66% of subjects, but depressive, dysthymic, and oppositional disorders occurred in 96% of those with B/P symptoms. Severity of the CDI was the best single discriminator between R and B/P subjects.

CONCLUSIONS

Adolescents with EDs in the early stage of their illness are similar to adults with EDs in the following ways: they meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for subtypes of EDs (excluding amenorrhea) and commonly have comorbid psychiatric disorders, especially depressive disorders. Patients with B/P symptoms can be distinguished from restricting subjects because they endorse significantly more ED-specific and nonspecific psychopathology and have a higher frequency of comorbid Axis I diagnoses (especially depressive disorders) than restricting patients. Oppositional defiant disorder (ODD) occurs more commonly in adolescents with EDs associated with B/P symptoms.

Authors+Show Affiliations

Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9653536

Citation

Geist, R, et al. "Binge/purge Symptoms and Comorbidity in Adolescents With Eating Disorders." Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, vol. 43, no. 5, 1998, pp. 507-12.
Geist R, Davis R, Heinmaa M. Binge/purge symptoms and comorbidity in adolescents with eating disorders. Can J Psychiatry. 1998;43(5):507-12.
Geist, R., Davis, R., & Heinmaa, M. (1998). Binge/purge symptoms and comorbidity in adolescents with eating disorders. Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, 43(5), 507-12.
Geist R, Davis R, Heinmaa M. Binge/purge Symptoms and Comorbidity in Adolescents With Eating Disorders. Can J Psychiatry. 1998;43(5):507-12. PubMed PMID: 9653536.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Binge/purge symptoms and comorbidity in adolescents with eating disorders. AU - Geist,R, AU - Davis,R, AU - Heinmaa,M, PY - 1998/7/8/pubmed PY - 1998/7/8/medline PY - 1998/7/8/entrez SP - 507 EP - 12 JF - Canadian journal of psychiatry. Revue canadienne de psychiatrie JO - Can J Psychiatry VL - 43 IS - 5 N2 - OBJECTIVE: To identify the diagnostic subtypes of eating disorders (EDs), the psychiatric comorbid diagnoses, and associated specific and nonspecific psychopathology in a series of 120 adolescents undergoing standardized assessment for an ED. METHOD: Consecutive patients referred to our large pediatric hospital for ED assessment completed a semistructured diagnostic interview for children and adolescents. The following self-report scales were administered to assess specific and nonspecific psychopathology: the Children's Depression Inventory (CDI), the Brief Symptom Inventory (BSI), the Eating Disorder Inventory 2 (EDI-2), and the Family Assessment Measure (FAM-III) of family functioning. RESULTS: Female subjects with a mean age of 14.5 years and a mean body mass index (BMI) of 18.1 comprised 93% of the sample. The restrictive subtypes of anorexia nervosa (AN) (43%) and eating disorder not otherwise specified (EDNOS) (16%) were the most common diagnoses. Patients with restricting symptoms (R) could be grouped together because they were more similar to each other with respect to self-report symptoms of psychopathology than they were to patients with binge/purge (B/P) symptoms and vice versa. Patients with R endorsed significantly fewer subjective symptoms, both ED-specific and nonspecific, and rated their families functioning better than did B/P patients. Comorbid, current major depressive disorders and dysthymic disorders occurred in 66% of subjects, but depressive, dysthymic, and oppositional disorders occurred in 96% of those with B/P symptoms. Severity of the CDI was the best single discriminator between R and B/P subjects. CONCLUSIONS: Adolescents with EDs in the early stage of their illness are similar to adults with EDs in the following ways: they meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for subtypes of EDs (excluding amenorrhea) and commonly have comorbid psychiatric disorders, especially depressive disorders. Patients with B/P symptoms can be distinguished from restricting subjects because they endorse significantly more ED-specific and nonspecific psychopathology and have a higher frequency of comorbid Axis I diagnoses (especially depressive disorders) than restricting patients. Oppositional defiant disorder (ODD) occurs more commonly in adolescents with EDs associated with B/P symptoms. SN - 0706-7437 UR - https://www.unboundmedicine.com/medline/citation/9653536/Binge/purge_symptoms_and_comorbidity_in_adolescents_with_eating_disorders_ L2 - http://journals.sagepub.com/doi/full/10.1177/070674379804300510?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -