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Dissociative Symptoms Associated With Phenotypical Characteristics in Eating Disorders: A Systematic Review
Myriam González-Gómez1, José M López-Villatoro1,2, Alejandra Galvez-Merlin1,2
1Psychiatry and Pathology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.
Clinical Psychology & Psychotherapy
|December 12, 2025
Summary
Dissociative symptoms are common in patients with eating disorders (EDs), particularly those with purging behaviors and identity issues. This prevalence may impact treatment and recovery outcomes for individuals with EDs.
Area of Science:
- Psychiatry
- Clinical Psychology
- Eating Disorders Research
Background:
- Eating disorders (EDs) frequently co-occur with dissociative symptoms.
- Dissociation is linked to increased risk of self-harm and suicide attempts in ED patients.
- Understanding dissociation in EDs is crucial for effective treatment and recovery.
Purpose of the Study:
- To investigate the prevalence of dissociative features in patients with eating disorders.
- To explore the relationship between dissociation and specific phenotypical characteristics of EDs.
Main Methods:
- A systematic review of scientific literature was conducted.
- Initial search yielded 651 studies; 32 were included in the final analysis.
- Inclusion and exclusion criteria were applied to select relevant articles.
Main Results:
- Dissociation is significantly more prevalent in ED patients compared to healthy individuals.
- ED patients exhibiting purgative symptoms show higher levels of dissociation than purely restrictive patients.
- Three psychological phenotypes associated with dissociation were identified: emotional-unstable, impulsive-aggressive, and cognitive-identity.
Conclusions:
- Dissociative symptoms are confirmed to be prevalent in eating disorders.
- Higher dissociation is observed in patients with a purging-impulsive-unstable profile.
- Difficulties related to identity are strongly associated with dissociative symptoms in ED.
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