Research
Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa
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* Corresponding author: Gen Komaki komaki@ncnp.go.jp
1 Department of Psychosomatic Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo 187-8553, Japan
2 Department of Social Science and Medicine, Course for Health Science, Kagoshima University Graduate School of Medical and Dental Science, 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8520, Japan
3 Division of Psychosomatic Medicine, Department of Neurology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-Nishi-ku, Kitakyushu-shi, Fukuoka 807-8555, Japan
4 Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka 812-8582, Japan
5 Department of Neuropsychiatry, Graduate School of Medicine, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka-shi, Osaka 545-8585, Japan
6 Tokyo Institute of Psychiatry, 2-1-8 Kamikitazawa, Setagaya-ku, Tokyo 156-8585, Japan
7 Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima-shi, Hiroshima 739-8521, Japan
8 Department of Psychosomatic Medicine, Tenri Hospital, 200 Mishima-cho, Tenri-shi, Nara 632-8552, Japan
9 Department of Internal Medicine, Hoshigaoka Maternity Hospital, 27 Inoue-cho, Chikusa-ku, Nagoya-shi, Aichi 464-0026, Japan
10 Division of General Medicine and Neuropsychiatry, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan
11 Department of Neuropsychiatry, School of Medicine, Sapporo Medical University, S-1, W-16, Chuo-ku, Sapporo-shi, Hokkaido 060-8543, Japan
12 Department of Internal Medicine, Yufuin Kohseinenkin Hospital, 252 Kawaminami, Ufuin-cho, Ufu-shi, Oita, 879-5193, Japan
13 Department of Psychosomatic Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayam, Hamamatsu-shi, Shizuoka 431-3192, Japan
14 Department of Psychosomatic Medicine, Nogami Hospital, 1-4-1 Komatsubara, Kagoshima-shi, Kagoshima 891-0114, Japan
15 Department of Psychosomatic Medicine, Kohnodai Hospital, National Center of Neurology and Psychiatry, 1-7-1 Kohnodai, Ichikawa-shi, Chiba 272-8516, Japan
BioPsychoSocial Medicine 2008, 2:5 doi:10.1186/1751-0759-2-5
Published: 12 February 2008Abstract
Background
Patients with anorexia nervosa-restricting type (AN-R) sometimes develop accompanying bulimic symptoms or the full syndrome of bulimia nervosa (BN). If clinicians could predict who might change into the bulimic sub-type or BN, preventative steps could be taken. Therefore, we investigated anthropometric and psychological factors possibly associated with such changes.
Method
All participants were from a study by the Japanese Genetic Research Group for Eating Disorders. Of 80 patients initially diagnosed with AN-R, 22 changed to the AN-Binge Eating/Purging Type (AN-BP) and 14 to BN for some period of time. The remaining 44 patients remained AN-R only from the onset to the investigation period. Variables compared by ANOVA included anthropometric measures, personality traits such as Multiple Perfectionism Scale scores and Temperament and Character Inventory scores, and Beck Depression Inventory-II scores.
Results
In comparison with AN-R only patients, those who developed BN had significantly higher current BMI (p < 0.05) and maximum BMI in the past (p < 0.05). They also scored significantly higher for the psychological characteristic of parental criticism (p < 0.05) and lower in self-directedness (p < 0.05), which confirms previous reports, but these differences disappeared when the depression score was used as a co-variant. No significant differences were obtained for personality traits or depression among the AN-R only patients irrespective of their duration of illness.
Conclusion
The present findings suggest a tendency toward obesity among patients who cross over from AN-R to BN. Low self-directedness and high parental criticism may be associated with the development of BN by patients with AN-R, although the differences may also be associated with depression.