A comparison of cognitive and behavioral symptoms between Mexican and American eating disorder patients

Mexican and U.S. patients with anorexia nervosa or bulimia (complete and partial syndromes) were compared on severity and types of preoccupations and rituals related to eating disorders and the motivation to change.

One hundred seventy-four patients who met DSM-IV criteria for anorexia nervosa, bulimia nervosa, or ED-NOS participated. Eighty-seven subjects entered treatment at the Instituto Nacional de Psiquiatría "Ramón de la Fuente" in Mexico City and were matched with 87 patients treated at the New York Presbyterian Hospital. Patients were interviewed with the Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS) (English or Spanish version).

All YBC-EDS scores were higher for the Mexican group, which also had a greater number of current preoccupations and rituals. U.S. and Mexican patients were quite similar in their endorsement of current preoccupations, but the Mexican group was more likely to have rituals in all checklist categories, and the rituals were more egosyntonic. More U.S. patients had received previous treatment for their eating disorder. A negative correlation was obtained between the amount of previous treatment and motivation to change the preoccupations and rituals (higher scores indicating lower motivation).

Cultural factors may influence characteristics of eating disorders. The previous treatment experiences of the U.S. patients seemed to positively influence their motivation for further treatment.