Comorbidity of DSM-III-R eating disorders and personality disorders

Abstract

The purpose of this study was to assess the relationship of eating disorders to personality disorders. Two hundred subjects were independently administered the Structured Clinical Interview for DSM‐III‐R (SCID) and the Personality Disorder Examination (PDE) face‐to‐face by two experienced clinicians. One hundred forty‐six also completed the Personality Diagnostic Questionnaire‐Revised (PDQ‐R). Rates of personality disorder among patients with and without eating disorders were determined by each of the three instruments. Comorbidity between bulimia nervosa and anorexia nervosa and a conservative estimate of individual Axis II disorders was examined. Eating disorders with and without personality disorders were compared on age at onset and two measures of illness severity. Results indicate that the association, in general, between personality disorders and eating disorders varies by diagnostic method. Bulimia nervosa, however, is associated with borderline personality disorder and anorexia nervosa with avoidant personality disorder. Eating disorders with personality disorders are characterized by chronicity and low levels of functioning compared with eating disorders without personality disorders. © 1993 by John Wiley & Sons, Inc.

The natural course of bulimia nervosa and eating disorder not otherwise specified is not influenced by personality disorders

“…Therefore, they cannot be generalized to males or to ED patients who present to specialty clinics for treatment. Given our recruitment focus (du Fort, Norman, & Bland, 1993), the rates of PD in our ED patients are higher than the rates reported in clinic samples (see reviews by Grilo, 2002;Skodol et al, 1993;Vitousek & Manke, 1994, for discussions of the extent and variability of co-occurrences among EDs and PDs across recruitment methods). Fairburn, Welch, Norman, O'Connor, and Doll (1996) reported differences in the patterns of psychopathology observed for patient (clinicrecruited) versus community samples of EDs, whereas Wilfley, Pike, Dohm, StriegelMoore, and Fairburn (2001) did not.…”

Anorexia nervosa and autism spectrum disorders: Guided investigation of social cognitive endophenotypes.

“…Notably, a constricted/overcontrolled type emerged characterized by behavioral inhibition, limited psychological insight, constricted emotional expression, shyness in social situations, anxiousness, and distortions in body image. This convergence, however, contrasts sharply with rates of categorically based personality disorder diagnoses in the group for which estimates range from 21% to 97% (Skodol et al, 1993;Vitousek & Manke, 1994). Despite this inconsistency, there is consensus that the anxious/fearful personality cluster predominates in AN (Wonderlich et al, 2005).…”

The relationship among binge severity, personality psychopathology, and body mass index

“…Findings have indicated that obese individuals who regularly binge exhibit more weight-related and general psychopathology than nonbinging obese individuals Kolotkin, Revis, Kirkley, & Janick, 1987;Marcus et al, 1990;Skodol et al, 1993;Spitzer et al, 1993;StriegelMoore, Wilson, Wilfley, Elder, & Brownell, 1998;Telch & Agras, 1994;Telch & Stice, 1998;Wadden, Foster, Letizia, & Wilk, 1993;Wilfley et al, 2000;Yanovski, Nelson, Dubbert, & Spitzer, 1993). In addition, they consume more calories than nonbinging obese women in a controlled setting (Goldfein, Walsh, LaChaussee, Kissileff, & Devlin, 1993;Yanovski et al, 1992).…”