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Anorexia nervosa as a compulsive behaviour disease.

I H Mills1, L Medlicott

  • 1Department of Medicine, University of Cambridge, Addenbrooke's Hospital.

The Quarterly Journal of Medicine
|July 1, 1992
PubMed
Summary

Many patients with eating disorders, including anorexia and bulimia, exhibit compulsive drives similar to those seen in compulsive personality disorder. These compulsive features are significant and should be considered in treatment approaches.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Eating Disorders Research

Background:

  • Anorexia nervosa and bulimia nervosa are serious eating disorders often characterized by intense, difficult-to-resist urges.
  • While these urges can feel compulsive, individuals with eating disorders do not always meet the criteria for obsessional-compulsive neurosis.
  • Understanding the nature of compulsive drives in eating disorders is crucial for effective therapeutic interventions.

Purpose of the Study:

  • To investigate the presence of compulsive drives in restricting anorexics.
  • To determine if compulsive personality disorder (DSM-III) features are present in individuals with eating disorders.
  • To compare compulsive features across different patient groups including controls, depressed patients, anorexics (bingeing and non-bingeing), and compulsive patients.

Main Methods:

  • Development and utilization of a questionnaire to assess compulsive drives and features.
  • Study population of 162 individuals: 42 controls, 30 depressed patients, 34 non-bingeing anorexics, 28 bingeing anorexics, and 28 compulsive patients.
  • Statistical analysis of questionnaire data to compare compulsion scale scores across groups.

Main Results:

  • The developed questionnaire proved to be a stable and reliable instrument.
  • Anorexic, bulimic, and compulsive patients scored significantly higher on the compulsion scale compared to controls (p < 0.005).
  • Compulsive patients did not exhibit anorexia-type eating disorders, suggesting distinct diagnostic profiles.

Conclusions:

  • Many underlying factors of compulsive personality disorder are present in primary eating disorders.
  • The compulsive nature of anorexia nervosa is a critical factor that cannot be overlooked in treatment planning.
  • The distinction between compulsive behavior and addiction is highlighted, particularly in light of the limited efficacy of naloxone in treating severe anorexia.

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