Should bulimia nervosa be subtyped by history of anorexia nervosa? A longitudinal validation

Int J Eat Disord. 2007 Nov:40 Suppl:S67-71. doi: 10.1002/eat.20422.

Abstract

Objective: To determine whether a past diagnosis of anorexia nervosa (AN) predicts longitudinal course and outcome among women with bulimia nervosa (BN).

Method: A subset (n = 176) of participants in the Longitudinal Study of Anorexia and Bulimia Nervosa who met DSM-IV criteria for BN either at study intake (n = 144) or during follow-up (n = 32; 4 had restricting AN at intake, 28 had binge/purge AN at intake) were included in this report. Over a median of 9 years, weekly eating disorder symptom data were collected from participants using the Longitudinal Interview Follow-up Examination, Eating Disorders Version.

Results: While there were no between-group differences in likelihood of partial recovery, women with BN who had a history of AN were more likely to have a protracted illness, relapsing into AN during follow-up, compared to those with no AN history who were more likely to move from partial to full recovery.

Conclusion: Lifetime AN is an important prognostic indicator among women with BN and these longitudinal data would support the subtyping of BN on the basis of AN history.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Anorexia Nervosa / epidemiology
  • Anorexia Nervosa / psychology*
  • Bulimia Nervosa / classification*
  • Bulimia Nervosa / diagnosis
  • Bulimia Nervosa / epidemiology
  • Bulimia Nervosa / psychology*
  • Child
  • Female
  • Humans
  • Longitudinal Studies
  • Multivariate Analysis
  • Proportional Hazards Models
  • Reproducibility of Results
  • United States / epidemiology