[The anorectic family--an old-fashioned concept]

The article updates Yager's 1982 review of familial factors in the pathogenesis of anorexia nervosa. The concept of "the anorectic family", as used by Minuchin and co-workers, although adequately describing a subgroup of families with an anorectic family member, is not a valid description of the group as a whole. No constellation of familial factors has been shown to be characteristic of the families of all anorexia patients. However, certain familial factors have been shown to be over-represented-e g, the presence of eating disorders, affective illness and alcoholism among close relative. Such "serious life events" as the loss of a close relative have also been shown to be over-represented among teenage girls with anorexia nervosa. The importance of these findings in connection with history taking is discussed. Future research should be designed to identify subgroups of anorexia nervosa patients for whom familial factors are of special significance, instead of treating anorexia nervosa as a uniform entity where the same set of aetiological factors (either genetic, psychological or interpersonal) are valid for all cases.