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Characterization of the "seasonal" bulimic patient
R D Levitan1, A S Kaplan, W Rockert
1Mood and Seasonal Affective Disorders Clinic, Clarke Institute of Psychiatry, Toronto, Canada.
Objective:
To determine whether bulimia nervosa (BN) patients who experience marked fall/winter worsening in eating behavior and/or mood are otherwise distinct from nonseasonal BN patients.
Methods:
We empirically identified "seasonal" and "nonseasonal" groups from a sample of 208 consecutive BN patients completing the Seasonal Pattern Assessment Questionnaire (SPAQ). t Tests were performed to determine if seasonal patients differed from nonseasonal patients with respect to demographic and weight variables, age of onset of symptoms, illness severity, and attitudes and beliefs.
Results:
Seasonal BN patients exhibited a greater discrepancy between maximum lifetime and current weight, an earlier age of onset of binging, and a higher current monthly binge frequency than did the nonseasonal group. Seasonal patients also scored significantly higher on the Bulimia and Interoceptive Awareness (reflecting lower self-awareness) subscales of the Eating Disorders Inventory (EDI).
Discussion:
The results suggest that seasonal BN patients may represent a distinct subgroup characterized by a low threshold for binging behavior, greater preoccupation with bulimic behaviors, poor awareness of moods and feelings, and a unique course of illness. More research is needed to confirm these initial findings and to further assess the effectiveness of light therapy for these patients.