The Parental Bonding Instrument (PBI) was administered to 54 adolescent patients with anorexia nervosa. Scores were compared with those of matched groups of normal and of nonanorectic adolescents referred for assessment to an adolescent psychiatric unit. Significant differences between the 3 groups were demonstrated with respect to care and protection dimensions. Overall scores of subjects in the anorectic group resembled those of normals rather than those of referred patients. Anorexia nervosa patients described their fathers and mothers as being more caring and their mothers as being less overprotective than did psychiatrically referred peers. The study raised questions concerning the use of the PBI in adolescents, in particular those with anorexia nervosa, and the role of the family in the aetiogenesis of this condition.
Cooper and Fairburn's Eating Disorder Examination (EDE) is a semi-structured interview designed to assess the specific psychopathology of eating disorder subjects. It was employed in a study of 116 Sydney patients for 2 purposes: first, to determine its usefulness in an Australian context; and second, to compare patients with anorexia nervosa, bulimia and atypical eating disorder. The instrument appears to be quite appropriate for studies in Australia. With respect to the second aim, the results emphasize the essential similarity in psychopathology between the three diagnostic groups. The relevance of this latter finding to the categorisation of eating disorders in the DSM-IV proposals is discussed.
Forty-five of 60 consecutive morbidly obese patients who had a vertical banded gastroplasty carried out by the one surgeon between 1982 and 1988 were assessed by questionnaire at long-term follow-up in 1993. Eighteen patients (40%) had maintained their BMI at close to the lowest achieved levels. Twenty-seven patients (60%) had had a significant rise in BMI, and 14 of these (31%) had gained weight to return close to or above their pre-surgery BMI levels. No reliable predictors of successful long-term weight loss were detected in the pre-operative data. Forty-eight patients (84%) were satisfied with their surgical treatment. Twenty patients (44%) reported improved social life after surgery. Twenty-one patients (46%) reported a similar social life and only four patients (9%) a worse social life. At follow up five patients (12%) reported emotional problems related to their weight loss surgery and two of this group had had psychiatric counseling for depression. Pre-operative psychiatric assessment appeared to have facilitated intervention by the psychiatrist with these patients. Gastric restrictive surgery, however, remains unpredictable in its long-term weight loss effect.
The demographic and clinical features of 12 male patients with anorexia nervosa were investigated by means of a retrospective analysis of their medical records. The clinical characteristics of the male patients were found to be remarkably similar to those reported for female patients and our findings concur with previously published literature. There appears however to be a greater tendency to exercise excessively. The importance of recognising anorexia nervosa in males is emphasized.
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