The Role of Depression and Anxiety in Impulsive and Obsessive-Compulsive Behaviors Among Anorexic and Bulimic Patients

Abstract

Eating disorders are believed to range across a spectrum of varying degrees of obsessive-compulsive and impulsive behavior. Sixty anorexic (mean age = 19.8; sd = 5.9) and 109 bulimic (mean age = 26.9; sd = 11.3) female patients completed self-report questionnaires assessing obsessive-compulsiveness, impulsivity, depression and anxiety, as well as two eating disorder scales. Results yielded significantly higher levels of impulsivity and negative body image in the bulimic compared to the anorexic group. Regression analysis predicting impulsivity showed that bulimia and negative body image were the main contributors. Regression analysis for predicting obsessive-compulsive behavior suggested that depression and anxiety obscure the link between anorexia and obsessive-compulsive behavior, and a high BMI intensifies the association between anxiety and obsessive-compulsive behavior. The high rates of both impulsivity and obsessive-compulsiveness found in both groups, and their association with the severity of the eating disorder, may suggest that impulsivity and obsessive-compulsiveness are not mutually exclusive and can both be found among anorexic and bulimic patients.

The Experience of Siblings of Adolescents With Eating Disorders

“…Although many AEDs have obsessive compulsive symptoms [33,34], we did not predict that these behaviors would cause such a high level of distress in their siblings. Studies have shown that obsessive-compulsive disorder can have adverse effects on the QOL of relatives of patients with obsessive-compulsive disorder.…”

Psychiatric and medical comorbidities of eating disorders: findings from a rapid review of the literature

“…Social anxiety was associated with more severe ED psychopathology and higher body weight [ 31 ] and acts as a barrier to accessing ED treatment [ 32 ] Obsessive compulsive disorder (OCD) (5 studies) The reported comorbidity rates of OCD and EDs were variable [ 33 ]. There is symptom overlap between OCD and EDs [ 34 ]; with evidence of OCD being related to more severe ED [ 34 ]; and treatment of one condition associated with symptom improvement in the other [ 35 ]. Further, comorbidity of OCD and EDs appears to be maintained by intrusive thoughts and perfectionism [ 36 ] Major depressive disorder (MDD)/depression (10 studies) Disordered eating may develop concurrently with depressive symptoms.…”

“…Similarities between the symptoms of Obsessive–Compulsive Disorder (OCD) and EDs, such as cognitive rigidity, obsessiveness, detail focus, perfectionism and compulsive routines have long been reported in the literature [ 34 ]. Given the symptom overlap, a meta-analysis sought to clarify the lifetime and current (that is, a current diagnosis at the time of data collection) comorbidity rates of OCD and EDs, noting the lifetime comorbidity rate was 18% and current comorbidity rate was 15% [ 33 ].…”

“…Prevalence rates of OCD seemed to be highest among people with AN (lifetime = 19% and current = 14%) compared to other ED subtypes. In addition to the symptom crossover, this RR found evidence of a complex relationship between OCD and EDs, including a potential association between OCD and greater ED severity [ 34 ].…”

Obsessive–Compulsive Symptoms and Body Checking in Women and Men

“…For example, Kaye et al (2004) reported a 41% life-time prevalence of OCD in a large sample (n = 672) of eating disorder patients. Self-reports of OCD symptoms are also highly correlated with measures of eating pathology and body image concerns among clinical samples (Finzi-Dottan and Zubery 2009;Jimenez-Murcia et al 2007) and among non-clinical samples (Roberts 2006). In many cases, OCD occurs prior to the onset of the eating disorder, suggesting that OCD might be a risk factor for eating disorders (Thornton and Russell 1997).…”