Hostname: page-component-6bf8c574d5-w79xw Total loading time: 0 Render date: 2025-02-22T04:47:52.377Z Has data issue: false hasContentIssue false
  • English
  • Français

Anxiety disorders in anorexia nervosa and bulimia nervosa: co-morbidity and chronology of appearance

Published online by Cambridge University Press:  16 April 2020

N.T. Godart ,
M.F. Flament ,
Y. Lecrubier  and
P. Jeammet
N.T. Godart
Affiliation:
Department of Psychiatry, Institut Mutualiste Montsouris,Paris, France
M.F. Flament
Affiliation:
CNRS UMR 7593, Hôpital La Salpêtrière,Paris, France
Y. Lecrubier
Affiliation:
INSERM U302, Hôpital La Salpêtrière,Paris, France
P. Jeammet
Affiliation:
Department of Psychiatry, Institut Mutualiste Montsouris,Paris, France
Get access

Summary

The objectives of the study were to assess lifetime prevalence of specific anxiety disorders, and their age of onset relative to that of eating disorders (ED), in a French sample of patients with anorexia nervosa (AN) or bulimia nervosa (BN). We assessed frequencies of seven anxiety disorders and childhood histories of separation anxiety disorder among 63 subjects with a current DSM-IV diagnosis of an ED, using the Composite International Diagnostic Interview (CIDI). Eighty-three percent of subjects with AN and 71% of those with BN had at least one lifetime diagnosis of an anxiety disorder. By far, the most frequent was social phobia (55% of the anorexics and 59% of the bulimics). When present, the co-morbid anxiety disorder had predated the onset of the ED in 75% of subjects with AN, and 88% of subjects with BN. Our results are consistent with those of studies conducted in other countries, and show that an anxiety disorder frequently exists before an ED. This has to be taken in consideration for successful treatment of patients with AN or BN.

Keywords

age of onsetanorexia nervosaanxiety disordersbulimia nervosaco-morbiditysocial phobia
Type
Original article
Information
European Psychiatry , Volume 15 , Issue 1 , 2000 , pp. 38 - 45
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders.. 3rd ed, rev 1987 Washington, DC: APAGoogle Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th 1994 Washington, DC: APAGoogle Scholar
Braun, D.L.Sunday, S.Halmi, K.A.Psychiatric comorbidity in patients with eating disorders. Psychol M 1994; 24: 859–867CrossRefGoogle ScholarPubMed
Brewerton, T.D.Lydiard, R.B.Ballenger, J.C.Herzog, D.B.Eating disorders and social phobia. Arch Gen Psychiatry 1993; 50: 70Google ScholarPubMed
Brewerton, T.D.Lydiard, R.B.Herzog, D.B.Brotman, A.W.O’Neil, P.M.Ballenger, J.C.Comorbidity of axe I psychiatric disorders in bulimia nervosa. J Clin Psychiatry 1995; 56: 77–80Google Scholar
Brewerton, T.D.Toward a unified theory of serotonin dysregulation in eating and related disorders. Psychoneuroendocrinology 1995; 20: 551–590CrossRefGoogle Scholar
Bulik, C.M.Sullivan, P.F.Carter, F.A.Joyce, P.R.Eating disorders and antecedent anxiety disorders: a controlled study. Acta Psychiatr Scand 1997; 96: 101–107CrossRefGoogle ScholarPubMed
Bulik, C.M.Sullivan, P.F.Carter, F.A.Joyce, P.R.Lifetime anxiety disorders in women with bulimia nervosa. Compr Psychiatry 1996; 37: 368–374CrossRefGoogle ScholarPubMed
Deep, A.L.Naguy, L.M.Weltzin, T.E.Rao, R.Kaye, W.H.Premorbid onset of psychopathology in long-term recovered anorexia nervosa. Int J Eat Disorder 1995; 17: 291–297Google ScholarPubMed
Fahy, T.A.Osacar, A.Marks, I.History of eating disorders in female patients with obsessive-compulsive disorder. Int J Eat Disorder 1993; 14: 439–4433.0.CO;2-6>CrossRefGoogle ScholarPubMed
Flament, M.F.Jeammet, P.Payan, C.Dantchev, N.Venisse, J.L.Bailly, D. et al. DSM-III-R / DSM-IV diagnoses and clinical characteristics of 539 consecutive outpatients with binge-eating: A French multicenter study.Widiger, T.A et al. DSM-IV Sourcebook 1998 Washington DC: American Psychiatric Association 533–552Google Scholar
Flament, M.F.La boulimie: Evolution des critères diagnostiques et aspects séméiologiques. Venisse, J.L 1991 Les Nouvelles Paris74–94Google Scholar
Fornari, V.Kaplan, M.Sandberg, D.E.Depressive and anxiety disorders in anorexia nervosa and bulimia nervosa. Int J Eat Disorder 12 1 1992 21–293.0.CO;2-Y>CrossRefGoogle Scholar
Herzog, D.B.Keller, M.B.Sacks, N.R.Yeh, C.J.Lavori, P.W.Psychiatric comorbidity in treatment-seeking anorexics and bulimics. J Am Act Adolesc Psychiatry 1992; 31: 810–81810.1097/00004583-199209000-00006CrossRefGoogle ScholarPubMed
Holden, N.L.Is anorexia nervosa an obsessive compulsive disorder? Br J Psychiatry 1990; 157: 1–5CrossRefGoogle ScholarPubMed
Hollander, E.Wong, C.M.Obsessive compulsive spectrum disorders. J Clin Psychiatry 1995; 56: 3–6Google ScholarPubMed
Hsu, G.Kaye, W.Welstin, T.Are the eating disorders related to obsessive compulsive disorders. Int J Eat Disorder 1993; 14: 305–3183.0.CO;2-L>CrossRefGoogle Scholar
Johnson, C.Larson, R.Bulimia: an analysis of moods behaviour. Psychosom M 1982; 44: 341–351CrossRefGoogle Scholar
Kasvikis, Y.G.Basoglu, H.Noshirvani, H.F.Past history of anorexia nervosa in women with obsessive compulsive disorder. Int J Eat Disorder 1986; 3: 1069–10753.0.CO;2-U>CrossRefGoogle Scholar
Keck, E.Pope, H.G.Hudson, J.I.Mc Elroy, S.L.Yurgelun-Todd, D.Hundert, E.M.A controlled study of phenomenology and family history in outpatients with bulimia nervosa. Compr Psychiatry 1990; 31: 275–283CrossRefGoogle ScholarPubMed
Kennedy, S.H.S.Garfinkel, P.E.Advances in diagnosis and treatment of anorexia nervosa and bulimia nervosa. Can J Psychiatr 1992; 5: 309–315CrossRefGoogle Scholar
Kessler, R.C.McGonagle, K.A.Zhao, S.Nelson, C.B.Hughes, M.Eshleman, S. et al. Life and twelve month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Arch Gen Psychiatry 1994; 51: 8–19CrossRefGoogle Scholar
Laessle, R.G.Wittchen, H.U.Fichter, M.M.Pirke, K.M.The significance of subgroups of bulimia and anorexia nervosa: lifetime frequency of psychiatric disorders. Int J Eat Disorder 1989; 8: 569–5743.0.CO;2-0>CrossRefGoogle Scholar
Lepine, J.P.Lellouch, J.Etude épidémiologique des troubles dépressifs et anxieux dans une population générale. Ann Med-Psychol 1993; 151: 618–622Google Scholar
Mannnuzza, SFyer, AKlein, D.Schedule for Schizophrenia and Affective Disorders Lifetime Version-Modified for the study of anxiety disorders New York: New-York State Psychiatric Institute: New-York; 1985. French trans, M Leboyer, M Teherani, JP Lépine, copyright INSERM; Paris 1992.Google Scholar
Mitchell, J.E.Speckert, S.M.DeZwaan, M.Comorbidity and medical complication of bulimia nervosa. J Clin Psychiatry 1991; 52: 13–20Google Scholar
Piran, N.Kennedy, S.Garfinkel, P.Owens, M.Affective disturbance in eating disorders. J Nerv Ment Dis 1985; 173: 395–400CrossRefGoogle ScholarPubMed
Pohl, R.Yeragani, V.K.Balon, R.Lycaki, H.Lactate and isoproterenol infusions in bulimic patients. Neuropsychol Biol 1989; 22: 225–230Google ScholarPubMed
Rastam, M.Anorexia nervosa in 51 Swedish adolescents: premorbid problems and comorbidity. J Am Act Adolesc Psychiatry 1992; 31: 819–829CrossRefGoogle ScholarPubMed
Robbins, L.N.Wing, J.W.Wittchen, H.U.Helzer, J.E.The Composite International Diagnostic Interview. Arch Gen Psychiatry 1988; 45: 1069–1077CrossRefGoogle Scholar
Schwalberg, M.D.Barlow, D.H.Alger, S.A.Howard, L.J.Comparison of bulimics, obeses, binge eaters, social phobics and individuals with panic disorders on comorbidity across DSM-III-R anxiety disorders. J Abnorm Psychol 1992; 101: 4675–4681CrossRefGoogle Scholar
Toner, B.B.Garfinkel, P.E.Garner, D.M.Affective and anxiety disorders in a long-term follow-up of anorexia nervosa. Int J Psychiat M 1988; 18: 357–364CrossRefGoogle Scholar
Wittchen, H.Zhao, S.Kessler, R.C.Eaton, W.W.DSM-III-R general anxiety disorder in the National Comorbidity Survey. Arch Gen Psychiatry 1994; 51: 355–364CrossRefGoogle ScholarPubMed
Wittchen, H.U.Essau, C.A.Epidemiology of panic attacks, panic disorder and agoraphobia.Walker, J.RNorton, RRoss, CPanic disorder and agoraphobia: a comprehensive guide for the practitioner 1991 California: Brooks/Cole 103–149Google Scholar
Wittchen, H.U.Essau, C.A.Epidemiology of anxiety disorders.Michels, RPsychiatry 1993 Phildadelphia: J. B. Lippincott 1–23Google Scholar
Wittchen, H.U.Nelson, C.B.Lachner, G.Prevalence of mental disorders and psychological impairments in adolescents and young adults. Psychol M 1998; 28: 109–126CrossRefGoogle Scholar
Wittchen, H.U.Robbin, L.N.Cottler, L.B.Sartorius, N.Burke, J.D.Regier, D.participants in the multicenter WHO/ADAMIA fields trials. Cross-cultural feasability, reability and sources of variance of the Composite International Diagnostic Interview (CIDI). Br J Psychiatry 1991; 159: 645–65310.1192/bjp.159.5.645CrossRefGoogle Scholar
World Health Organisation. CIDI core computer manual for data entry and diagnostic programmes for the Composite International Diagnostic Interview (CIDI) (Version 1. 0, REV. 4,1990)French version directed by Pull. 1991Google Scholar
Submit a response

Comments

No Comments have been published for this article.