Comorbidity of DSM-III-R eating disorders and personality disorders

The purpose of this study was to assess the relationship of eating disorders to personality disorders. Two hundred subjects were independently administered the Structured Clinical Interview for DSM-III-R (SCID) and the Personality Disorder Examination (PDE) face-to-face by two experienced clinicians. One hundred forty-six also completed the Personality Diagnostic Questionnaire-Revised (PDQ-R). Rates of personality disorder among patients with and without eating disorders were determined by each of the three instruments. Comorbidity between bulimia nervosa and anorexia nervosa and a conservative estimate of individual Axis II disorders was examined. Eating disorders with and without personality disorders were compared on age at onset and two measures of illness severity. Results indicate that the association, in general, between personality disorders and eating disorders varies by diagnostic method. Bulimia nervosa, however, is associated with borderline personality disorder and anorexia nervosa with avoidant personality disorder. Eating disorders with personality disorders are characterized by chronicity and low levels of functioning compared with eating disorders without personality disorders.