RESUMEN
OBJECTIVES: The current standards for classifying eating disorders were primarily informed by adult, clinical study populations, while it is unknown whether an empirically based classification system can be supported across preadolescence through young adulthood. Using latent class analyses, we sought to empirically classify disordered eating in females from preadolescence to young adulthood, and assess the association between classes and adverse outcomes. METHOD: Latent class models were fit using observations from the 9,039 girls participating in the growing up today study, an on-going cohort following participants annually or biennially since 1996 when they were ages 9-14 years. Associations between classes and drug use, binge drinking, and depressive symptoms were assessed using generalized estimating equations. RESULTS: Across age groups, there was evidence of six classes: a large asymptomatic class, a class characterized by shape/weight concerns, a class characterized by overeating without loss of control, and three resembling full and subthreshold binge eating disorder, purging disorder, and bulimia nervosa. Relative prevalences of classes varied across developmental stages, with symptomatic classes increasing in prevalence with increasing age. Symptomatic classes were associated with concurrent and incident drug use, binge drinking, and high depressive symptoms. DISCUSSION: A classification system resembling broader definitions of DSM-5 diagnoses along with two further subclinical symptomatic classes may be a useful framework for studying disordered eating among adolescent and young adult females.
Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Adolescente , Adulto , Trastorno por Atracón/clasificación , Trastorno por Atracón/psicología , Peso Corporal , Niño , Depresión/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/clasificación , Femenino , Humanos , Hiperfagia/clasificación , Hiperfagia/psicología , Prevalencia , Trastornos Relacionados con Sustancias/psicología , Adulto JovenRESUMEN
OBJECTIVES: Nocturnal eating is a common symptom of two clinical conditions with different pathogenesis and needing different therapeutic approaches: Sleep Related Eating Disorder (SRED) and Night Eating Syndrome (NES). The first is considered a parasomnia while the second is an eating disorder; however, the distinction between SRED and NES is still a controversial matter. The aim of this study was to better define psychological, behavioral, and polysomnographic characteristics of the two syndromes. METHODS: An eating disorders' specialist tested a group of 28 nocturnal eaters diagnosed as affected by SRED by a sleep expert, following the current criteria of the international classification of sleep disorders, to find out if any of them was affected by NES according to the criteria suggested by both sleep and eating disorders specialists during the first international meeting on Night Eating Syndrome (Minneapolis, 2009) and if they had specific psychological or polysomnographic characteristics. RESULTS: Twenty-two subjects were diagnosed to be affected by NES. They scored higher on the physical tension subscale of the Sleep Disturbance Questionnaire (SDQ) and on the mood and sleep subscale of the Night Eating Questionnaire (NEQ), but there were no other significant differences between SRED and NES patients nor for age, Body Mass Index (BMI), or gender distribution. CONCLUSIONS: The overlap between the symptomatology and the polysomnographic characteristics of the two pathologies and the difficulty in making a differential diagnosis between NES and SRED indicate the need for an update of the diagnostic criteria for SRED, as was recently done for NES.
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Trastornos de Alimentación y de la Ingestión de Alimentos/clasificación , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Clasificación Internacional de Enfermedades/normas , Parasomnias/clasificación , Parasomnias/diagnóstico , Psicopatología/normas , Adulto , Ansiedad/clasificación , Ansiedad/diagnóstico , Femenino , Humanos , Hiperfagia/clasificación , Hiperfagia/diagnóstico , Masculino , Persona de Mediana Edad , Polisomnografía , Trastornos del Despertar del Sueño/clasificación , Trastornos del Despertar del Sueño/diagnóstico , Trastornos del Inicio y del Mantenimiento del Sueño/clasificación , Trastornos del Inicio y del Mantenimiento del Sueño/diagnósticoRESUMEN
Overeating and associated obesity are major public health problems. In addition to its notable adverse health consequences, the behavior of overeating has significant neurobiological and psychological underpinnings. Current classification systems of mental disorders (DSM-IV and ICD-10) address this increasingly prevalent "disorder" in a limited and inconsistent manner. Several similarities between overeating and substance dependence have been documented with regards to phenomenology, shared neurobiology, and treatment. This has led to suggestions that a new category of "food addiction" be added to our psychiatric nosology and that this category be included with substance use disorders under a broad rubric of "addiction disorders". In this article, we consider the rationale for this recommendation and evaluate its pros and cons. We summarize how the problem of overeating is addressed in our current classification systems and discuss DSM-5 approaches to the issue.
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Conducta Adictiva/clasificación , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos de Alimentación y de la Ingestión de Alimentos/clasificación , Hiperfagia/clasificación , Obesidad/clasificación , Animales , Conducta Adictiva/psicología , HumanosRESUMEN
Many "new" syndromes have been proposed for inclusion in the DSM-V. Some disorders acquired popularity through the Internet, but will they be taken seriously and get accepted by the scientific community? We organized an opinion poll among professionals in the field of eating disorders by presenting them a provisional set of diagnostic criteria of four "new" disorders: Night Eating Syndrome, Orthorexia, Muscle Dysmorphia, and Emetophobia. In general, the opinions did not differ much according to the characteristics of the 111 respondents. Among these professionals, Orthorexia is the best known and Night Eating Syndrome the least. Although the majority is familiar with the concept of Muscle Dysmorphia, it is most often viewed as a creation of the popular media and rarely observed in daily practice. In contrast, the other three disorders seem to be taken more seriously in the sense of "genuine" syndromes, which should receive more attention in research and clinical practice. Emetophobia appears to be the least "fashionable" of the four. The findings are discussed in the light of medialization and medicalization.
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Actitud del Personal de Salud , Trastorno Dismórfico Corporal/diagnóstico , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Hiperfagia/diagnóstico , Trastorno Dismórfico Corporal/clasificación , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos de Alimentación y de la Ingestión de Alimentos/clasificación , Encuestas de Atención de la Salud , Humanos , Hiperfagia/clasificación , Medios de Comunicación de MasasRESUMEN
OBJECTIVE: To propose criteria for diagnosis of the night eating syndrome (NES). METHOD: An international research meeting was held in April 2008, and consensus criteria for NES diagnosis were determined. RESULTS: The core criterion is an abnormally increased food intake in the evening and nighttime, manifested by (1) consumption of at least 25% of intake after the evening meal, and/or (2) nocturnal awakenings with ingestions at least twice per week. Awareness of the eating episodes is required, as is distress or impairment in functioning. Three of five modifiers must also be endorsed. These criteria must be met for a minimum duration of 3 months. DISCUSSION: These criteria help standardize the definition of NES. Additional aspects of the nosology of NES yet to be fully elaborated include its relationship to other eating and sleep disorders. Assessment and analytic tools are needed to assess these new criteria more accurately.
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Ritmo Circadiano , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Concienciación , Comorbilidad , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Diagnóstico Diferencial , Trastornos de Alimentación y de la Ingestión de Alimentos/clasificación , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Humanos , Hiperfagia/clasificación , Hiperfagia/diagnóstico , Hiperfagia/psicología , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Trastornos del Inicio y del Mantenimiento del Sueño/psicologíaRESUMEN
Criteria for inclusion of diagnoses of Axis I disorders in the forthcoming Diagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association are being considered. The 5 criteria that were proposed by Blashfield et al as necessary for inclusion in DSM-IV are reviewed and are met by the night eating syndrome (NES). Seventy-seven publications in refereed journals in the last decade indicate growing recognition of NES. Two core diagnostic criteria have been established: evening hyperphagia (consumption of at least 25% of daily food intake after the evening meal) and/or the presence of nocturnal awakenings with ingestions. These criteria have been validated in studies that used self-reports, structured interviews, and symptom scales. Night eating syndrome can be distinguished from binge eating disorder and sleep-related eating disorder. Four additional features attest to the usefulness of the diagnosis of NES: (1) its prevalence, (2) its association with obesity, (3) its extensive comorbidity, and (4) its biological aspects. In conclusion, research on NES supports the validity of the diagnosis and its inclusion in DSM-V.
Asunto(s)
Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Trastornos del Sueño-Vigilia/diagnóstico , Bulimia Nerviosa/clasificación , Bulimia Nerviosa/diagnóstico , Bulimia Nerviosa/epidemiología , Comorbilidad , Estudios Transversales , Diagnóstico Diferencial , Trastornos de Alimentación y de la Ingestión de Alimentos/clasificación , Trastornos de Alimentación y de la Ingestión de Alimentos/epidemiología , Humanos , Hiperfagia/clasificación , Hiperfagia/diagnóstico , Hiperfagia/epidemiología , Obesidad/epidemiología , Trastornos del Sueño-Vigilia/clasificación , Trastornos del Sueño-Vigilia/epidemiologíaRESUMEN
OBJECTIVE: To review the empirical literature for evidence in support of inclusion of Night Eating Syndrome (NES) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. METHOD: Based on a literature search using PubMed, 47 empirical studies of NES were identified. RESULTS: The literature reflects use of varying definitions; progress has been made toward reliable measurement of night eating symptoms; evidence regarding a differentiation of NES from "normalcy" or from other eating disorders is based largely on samples of convenience; only one controlled treatment study has been published. DISCUSSION: There are limited data supporting the clinical utility and validity of NES; several options regarding the inclusion of NES in DSM-V are discussed.
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Disomnias/clasificación , Trastornos de Alimentación y de la Ingestión de Alimentos/clasificación , Hiperfagia/clasificación , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Disomnias/diagnóstico , Conducta Alimentaria/clasificación , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Humanos , Hiperfagia/diagnóstico , Reproducibilidad de los ResultadosRESUMEN
BACKGROUND: Atypical depression has been found to be distinct from other types of depression in terms of psychiatric symptom profile and treatment response. However, debate continues regarding its specific characteristics, impact, and diagnostic criteria. The current study was conducted to increase understanding of atypical depression diagnosed using only the reversed vegetative symptoms of hypersomnia and hyperphagia. METHODS: An atypical depression group (n = 304 [36.4% of the depressed sample; 39.0% when weighted to approximate the national population]) was identified within the US National Comorbidity Survey, which assessed psychiatric disorders among a nationally representative sample using the Composite International Diagnostic Interview. The atypical group was identified based on DSM-III-R criteria for a major depressive episode, in addition to atypical features of hypersomnia and hyperphagia. Comparison groups were those with nonatypical depression (n = 532) and individuals without a psychiatric disorder (n = 4071). RESULTS: Compared with nonatypical depression, atypical depression was associated with a greater percentage of women and an earlier age of onset. The atypical group also reported higher rates of most depressive symptoms, suicidal thoughts and attempts, psychiatric comorbidity (panic disorder, social phobia, and drug dependence), disability and restricted activity days, use of some health care services, paternal depression, and childhood neglect and sexual abuse (P<.05). Compared with people without psychiatric disorders, the atypical group reported higher rates of disability and restricted activity days, use of all mental health care services, parental depression, and childhood abuse (P<.001). CONCLUSIONS: This analysis of a nationally representative US sample suggests that overeating and oversleeping can be used to identify an atypical depression subgroup that is distinct from other depressed patients in terms of demographics, psychiatric comorbidities, and abuse history. Findings also suggest that atypical depression is associated with increased distress, suicidal ideation, and disability compared with nonatypical depression.
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Trastorno Depresivo/diagnóstico , Trastornos de Somnolencia Excesiva/diagnóstico , Hiperfagia/diagnóstico , Actividades Cotidianas/clasificación , Actividades Cotidianas/psicología , Adolescente , Adulto , Comorbilidad , Estudios Transversales , Trastorno Depresivo/clasificación , Trastorno Depresivo/epidemiología , Trastorno Depresivo/psicología , Diagnóstico Diferencial , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Evaluación de la Discapacidad , Trastornos de Somnolencia Excesiva/clasificación , Trastornos de Somnolencia Excesiva/epidemiología , Trastornos de Somnolencia Excesiva/psicología , Femenino , Encuestas Epidemiológicas , Humanos , Hiperfagia/clasificación , Hiperfagia/epidemiología , Hiperfagia/psicología , Incidencia , Masculino , Persona de Mediana Edad , Factores de Riesgo , Intento de Suicidio/psicología , Intento de Suicidio/estadística & datos numéricos , Estados Unidos/epidemiologíaAsunto(s)
Trastorno Depresivo/clasificación , Trastorno Depresivo/diagnóstico , Análisis por Conglomerados , Comorbilidad , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos de Somnolencia Excesiva/clasificación , Trastornos de Somnolencia Excesiva/diagnóstico , Femenino , Humanos , Hiperfagia/clasificación , Hiperfagia/diagnóstico , Masculino , Valor Predictivo de las Pruebas , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Reproducibilidad de los Resultados , Proyectos de Investigación/normas , SíndromeRESUMEN
OBJECTIVE: The purpose of this investigation was to establish the criterion validity of the Multiaxial Assessment of Eating Disorders Symptoms (MAEDS). The MAEDS is a brief, comprehensive, self-report measure for the evaluation of eating disorders treatment outcome. It assesses six symptoms associated with eating disorders with subscales for binge eating, purgative behavior, avoidance of forbidden foods, restrictive eating, fear of fatness, and depression. METHOD: To establish criterion validity, we compared the subscale scores of the MAEDS across four eating disorder diagnoses, specified by subtype (bulimia nervosa, purging type; anorexia nervosa, binge-eating/purging type; anorexia nervosa, restricting type; and binge eating disorder). Participants who did not meet the full diagnostic criteria for an eating disorder, but who did meet criteria for a partial syndrome eating disorder, were grouped with the full eating disorder diagnostic subtypes. RESULTS: The criterion validity of the MAEDS was supported by the pattern of subscale scores for the different eating disorder diagnostic groups. Also, with few exceptions, persons diagnosed with anorexia nervosa, bulimia nervosa, and binge eating disorder, in comparison to subthreshold cases of anorexia nervosa, bulimia nervosa, and binge eating disorder, had equivalent scores on the subscales of the MAEDS. DISCUSSION: These findings support the criterion validity of the MAEDS and add to a growing literature that questions differences in severity of eating disorder symptoms in full syndrome versus partial syndrome cases.
Asunto(s)
Anorexia Nerviosa/diagnóstico , Bulimia/diagnóstico , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Adulto , Anorexia Nerviosa/clasificación , Anorexia Nerviosa/psicología , Bulimia/clasificación , Bulimia/psicología , Femenino , Humanos , Hiperfagia/clasificación , Hiperfagia/diagnóstico , Hiperfagia/psicología , Psicometría , Reproducibilidad de los ResultadosRESUMEN
This study compares the core and associated features of binge eating disorder (BED) and bulimia nervosa (BN). One hundred twenty-nine adult females who were obese with BED (n = 51) or non-obese with BED (n = 32) or who had BN (n = 46) were compared using the Eating Disorder Examination-Questionnaire (EDE-Q). The BED groups were older and had a higher body mass index (BMI). The 3 groups were similar in binge frequency, but BN subjects (by definition) purged regularly. The groups differed by dietary restraint, even after controlling for BMI and age, such that the BN group had significantly higher dietary restraint than both BED groups. Cognitively, the 3 groups were similar in the intensity of dysfunctional attitudes regarding eating, weight, and shape. The BMI and age were not associated with these dysfunctional attitudes. Our findings suggest the importance of and the need to consider cognitive--as well as behavioral--diagnostic criteria for BED.
Asunto(s)
Bulimia/diagnóstico , Hiperfagia/diagnóstico , Adolescente , Adulto , Anciano , Actitud Frente a la Salud , Imagen Corporal , Índice de Masa Corporal , Peso Corporal , Bulimia/clasificación , Bulimia/psicología , Femenino , Humanos , Hiperfagia/clasificación , Hiperfagia/psicología , Persona de Mediana Edad , Escalas de Valoración PsiquiátricaRESUMEN
The study objective was to evaluate the within-category cohesiveness and between-category overlap of DSM-IV axis II personality disorders (PDs) in outpatients with binge eating disorder (BED). Seventy adult outpatients with BED were reliably administered the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). Within-category interrelatedness of the criteria was evaluated by Cronbach's alpha and mean intercriterion correlations (MICs). Between-category criterion overlap was evaluated by examining intercategory mean intercriterion correlations between all pairs of PDs (ICMICs). Cronbach's alpha was .64 to .93 (mean, .77), the MIC was .17 to .52 (mean, .34), and the ICMIC was .11 to .39 (mean, .28). Our findings indicate that in outpatients with BED, the DSM-IV PD criteria sets have convergent validity (acceptable alpha value and MIC). Some degree of discriminant validity also exists: criteria for most DSM-IV PDs correlate better with each other (MIC) than with criteria for other PDs (ICMIC).
Asunto(s)
Bulimia/diagnóstico , Hiperfagia/diagnóstico , Trastornos de la Personalidad/diagnóstico , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Adulto , Atención Ambulatoria , Bulimia/clasificación , Bulimia/psicología , Femenino , Humanos , Hiperfagia/clasificación , Hiperfagia/psicología , Masculino , Persona de Mediana Edad , Trastornos de la Personalidad/clasificación , Trastornos de la Personalidad/psicología , Psicometría , Reproducibilidad de los ResultadosRESUMEN
The present study examined the psychopathology associated with binge eating disorder (BED), a new diagnostic category proposed for DSM-IV to classify patients with significant binge eating problems in the absence of purging. Self-report measures of psychopathology (e.g., depression, anxiety) and body image disturbance were administered to 72 women who prospectively (1) met criteria for BED (DSM-IV criteria), (2) reported frequent bingeing but did not meet BED criteria, and (3) denied problems with eating. Subjects satisfying BED criteria reported higher levels of psychopathology than normals on all measures and subclinical binge eaters scored between these two groups, but they were closer to subjects without eating problems. The pattern of results was essentially unchanged when corrected for weight. BED subjects and subclinical binge eaters were less satisfied with their bodies than were normal controls. These findings suggest that BED is not only characterized by frequent bingeing, but more importantly is associated with elevated psychopathology. Overall, these results lend support to the diagnostic criteria proposed for BED.
Asunto(s)
Bulimia/psicología , Hiperfagia/psicología , Adulto , Trastornos de Ansiedad/clasificación , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/psicología , Imagen Corporal , Bulimia/clasificación , Bulimia/diagnóstico , Trastorno Depresivo/clasificación , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Diagnóstico Diferencial , Dieta Reductora/psicología , Femenino , Humanos , Hiperfagia/clasificación , Hiperfagia/diagnóstico , Obesidad/psicología , Inventario de Personalidad , Escalas de Valoración Psiquiátrica , PsicopatologíaRESUMEN
In order to examine the eating behavior of individuals with the newly proposed diagnosis, binge eating disorder (BED), standardized meals were served to 20 obese women, 10 with BED and 10 without BED. When asked to binge eat from a multiple-item array of foods, obese subjects with BED consumed significantly more calories than did obese subjects without BED. Significant differences between the two groups were also found on several of the self-report measures.
Asunto(s)
Bulimia/psicología , Conducta Alimentaria , Hiperfagia/psicología , Obesidad/psicología , Adulto , Índice de Masa Corporal , Peso Corporal , Bulimia/clasificación , Bulimia/diagnóstico , Ingestión de Energía , Femenino , Humanos , Hiperfagia/clasificación , Hiperfagia/diagnóstico , Persona de Mediana Edad , Obesidad/clasificación , Obesidad/diagnósticoRESUMEN
Binge eating disorder (BED) is a new eating disorder that describes the eating disturbance of a large number of individuals who suffer from recurrent binge eating but who do not regularly engage in the compensatory behaviors to avoid weight gain seen in bulimia nervosa. This multisite study of BED involved 1,785 subjects drawn from 18 weight control programs, 942 subjects from five nonpatient community samples, and 75 patients with bulimia nervosa. Approximately 29% of subjects in weight control programs met the criteria for BED. In the nonpatient community samples BED was more common than purging bulimia nervosa. The validity of BED was supported by its strong association with (1) impairment in work and social functioning, (2) overconcern with body/shape and weight, (3) general psychopathology, (4) significant amount of time in adult life on diets, (5) a history of depression, alcohol/drug abuse, and treatment for emotional problems.
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Bulimia/diagnóstico , Hiperfagia/diagnóstico , Adolescente , Adulto , Anciano , Imagen Corporal , Índice de Masa Corporal , Peso Corporal , Bulimia/clasificación , Bulimia/psicología , Bulimia/terapia , Terapia Cognitivo-Conductual , Conducta Compulsiva/diagnóstico , Conducta Compulsiva/psicología , Depresión/diagnóstico , Depresión/psicología , Dieta Reductora/psicología , Femenino , Humanos , Hiperfagia/clasificación , Hiperfagia/psicología , Hiperfagia/terapia , Persona de Mediana Edad , Obesidad/clasificación , Obesidad/diagnóstico , Obesidad/psicología , Obesidad/terapia , Inventario de PersonalidadRESUMEN
Extensive recent research supports a proposal that a new eating disorder, binge eating disorder (BED), be included in DSM-IV. BED criteria define a relatively pure group of individuals who are distressed by recurrent binge eating who do not exhibit the compensatory features of bulimia nervosa. This large number of patients currently can only be diagnosed as eating disorder not otherwise specified (EDNOS). Recognizing this new disorder will help stimulate research and clinical programs for these patients. Fairburn et al.'s critique of BED fails to acknowledge the large body of knowledge that indicates that BED represents a distinct and definable subgroup of eating disordered patients and that the diagnosis provides useful information about psychopathology, prognosis, and outcome (Fairburn, Welch, & Hay [in press]. The classification of recurrent overeating: The "binge eating disorder" proposal. International Journal of Eating Disorders.) Against any reasonable standard for adding a new diagnosis to DSM-IV, BED meets the test.
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Bulimia/clasificación , Hiperfagia/clasificación , Escalas de Valoración Psiquiátrica , Anorexia Nerviosa/clasificación , Anorexia Nerviosa/diagnóstico , Anorexia Nerviosa/psicología , Bulimia/diagnóstico , Bulimia/psicología , Humanos , Hiperfagia/diagnóstico , Hiperfagia/psicologíaRESUMEN
It has been suggested that a new diagnostic category be added to the section on eating disorders in DSM-IV. This new diagnosis has been termed binge eating disorder. In this article we argue that for two main reasons it would be a mistake to include binge eating disorder in DSM-IV: first, too little is known about binge eating and other related forms of recurrent overeating to justify its inclusion in DSM-IV; and second, its inclusion would be a source of diagnostic confusion. We argue that it is premature to crystallize this specific subgroup from amongst those who recurrently overeat and that to do so would impede the acquisition of knowledge rather than enhance it. We advocate a research strategy that involves studying broad samples of those with recurrent overeating rather than narrow ones.
Asunto(s)
Bulimia/clasificación , Hiperfagia/clasificación , Escalas de Valoración Psiquiátrica , Anorexia Nerviosa/clasificación , Anorexia Nerviosa/diagnóstico , Anorexia Nerviosa/psicología , Bulimia/diagnóstico , Bulimia/psicología , Humanos , Hiperfagia/diagnóstico , Hiperfagia/psicología , RecurrenciaAsunto(s)
Anorexia Nerviosa/clasificación , Trastornos de Alimentación y de la Ingestión de Alimentos/clasificación , Hiperfagia/clasificación , Adolescente , Adulto , Anorexia Nerviosa/diagnóstico , Imagen Corporal , Peso Corporal , Femenino , Humanos , Hiperfagia/diagnóstico , Manuales como AsuntoRESUMEN
Sociodemographic and psychodynamic similarities and differences among four subgroups of eating disordered females seeking outpatient consultations for anorexia nervosa and bulimia are presented. Supporting the spectrum concept of eating disorders, the four diagnostic subgroups are: anorexia nervosa, restricting; anorexia nervosa with bulimic complications; normal weight bulimia with a history of anorexia nervosa; and normal weight bulimia without a history of anorexia nervosa. Overall, the 165 patients are white, middle to upper-middle class females in their early twenties. The highest levels of psychopathology, as measured by the Eating Disorder Inventory, was manifested by patients afflicted with both anorexic and bulimic symptomatology, either in the past or at time of consultation. Implications for diagnostic classification and clinical intervention are discussed.