Dissociative Symptoms Associated With Phenotypical Characteristics in Eating Disorders: A Systematic Review

Patients with eating disorders (EDs) often exhibit associated dissociative symptomatology, which could hinder ED treatment and recovery. Similarly, dissociation also appears to be linked to other risk behaviours, such as self-harm and suicide attempts that are commonly present in these patients. This study seeks to investigate the presence of dissociative features in ED and its relationship with the different phenotypical characteristics of these disorders.

A systematic review of scientific literature concerning the association of dissociative features and ED was performed. From an initial sample of 651 studies reviewed, 32 articles were included in the analysis after applying the inclusion and exclusion criteria.

The review analysis indicates that dissociation is more prevalent in ED patients than in healthy subjects. In addition, ED patients with purgative symptoms exhibit greater dissociation than purely restrictive patients. Finally, three psychological phenotypes were identified in association with dissociative symptoms: emotional-unstable, impulsive-aggressive and cognitive-identity.

Results confirm that dissociative symptoms are prevalent in ED, particularly among patients with a purging-impulsive-unstable profile and those with identity-related difficulties.