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Course of multi-impulsive bulimia

Published online by Cambridge University Press:  09 July 2009

M. M. Fichter ,
N. Quadflieg  and
W. Rief
M. M. Fichter*
Affiliation:
Department of Psychiatry, University of Munich; Klinik Roseneck, Prien (affiliated with the Medical Faculty of the Ludwig-Maximilians-University of Munich), Germany
N. Quadflieg
Affiliation:
Department of Psychiatry, University of Munich; Klinik Roseneck, Prien (affiliated with the Medical Faculty of the Ludwig-Maximilians-University of Munich), Germany
W. Rief
Affiliation:
Department of Psychiatry, University of Munich; Klinik Roseneck, Prien (affiliated with the Medical Faculty of the Ludwig-Maximilians-University of Munich), Germany
*
1Address for correspondence: Professor M. M. Fichter, Department of Psychiatry, University of Munich, Nussbaumstrasse 7, 80336 München, Germany
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Synopsis

Thirty-two consecutively admitted females with bulimia nervosa (purging type) according to DSM-IV and additional impulsive behaviours (multi-impulsive bulimia (MIB)) and 32 age-matched female controls with DSM-IV bulimia nervosa (purging type) (uni-impulsive bulimia (UIB)) were assessed longitudinally on admission and at discharge following in-patient therapy and at a 2-year follow-up. Multi-impulsive bulimics were defined as presenting at least three of the six of the following impulsive behaviours in their life-time in addition to their bulimic symptoms at admission: (a) suicidal attempts, (b) severe autoaggression, (c) shop lifting (other than food), (d) alcohol abuse, (e) drug abuse, or (f) sexual promiscuity. Multi-impulsive bulimics were more frequently separated or divorced, had less schooling and held less-skilled jobs. Except for interoceptive awareness (EDI), which was more disturbed in multi-impulsive bulimics, there were no differences concerning scales measuring eating disturbances and related areas. Multi-impulsive bulimics showed more general psychopathology – anxiety, depression, anger and hostility, psychoticism – differed in several personality scales from uni-impulsive bulimics (e.g. increased excitability and anger/hostility) and had overall a less favourable course of illness. Multi-impulsive bulimics also received more in- and out-patient therapy previous to the index treatment and during the follow-up period. The data support the notion that ‘multi-impulsive bulimia’ or ‘multi-impulsive disorder’ should be classified as a distinct diagnostic group on axis I or that an ‘Impulsive Personality Disorder’ should be introduced on axis II. The development of more effective treatment for multi-impulsive bulimia is warranted.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 3 , August 1994 , pp. 591 - 604
Copyright
Copyright © Cambridge University Press 1994

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