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Subtyping eating disorders: is it justified?

D B Herzog1, A E Field, M B Keller

  • 1Harvard Medical School, Boston, MA, USA.

Journal of the American Academy of Child and Adolescent Psychiatry
|July 1, 1996
PubMed
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This study found that women with bulimic anorexia nervosa had a higher recovery rate than those with restricting anorexia nervosa. These findings suggest that bulimic symptoms may influence the course and prognosis of anorexia nervosa.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Eating Disorders Research

Background:

  • The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) classifies anorexia nervosa into subtypes based on the presence or absence of bulimic symptoms.
  • Investigating the prognostic significance of these subtypes, particularly the role of bulimic symptoms in recovery, is crucial for refining diagnostic criteria and treatment approaches.

Purpose of the Study:

  • To assess whether the presence of bulimic symptoms in individuals with anorexia nervosa is associated with a different probability of recovery.
  • To provide empirical justification for the continued subtyping of anorexia nervosa based on symptomatology.

Main Methods:

  • A cohort of 225 women seeking treatment for anorexia nervosa and/or bulimia nervosa was prospectively followed.

Related Experiment Videos

  • Interviews were conducted every 3 months for up to 4 years.
  • Survival analysis methods were employed to analyze recovery rates.

    • Main Results:

    • Overall recovery rates were less than 50%, although most participants showed a reduction in symptoms over time.
    • Contrary to some previous research, individuals with bulimic anorexia nervosa demonstrated a higher recovery rate compared to those with restricting anorexia nervosa.
    • The presence of bulimic symptoms was associated with a more favorable recovery trajectory.

    Conclusions:

    • The observed differences in the course of illness, specifically recovery rates, offer some support for the clinical utility of subtyping anorexia nervosa.
    • Further prospective research is recommended to definitively establish the validity and clinical warrant for these anorexia nervosa subtypes.