Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-22T08:24:22.769Z Has data issue: false hasContentIssue false
  • English
  • Français

Personality Disorder and Treatment Response in Bulimia Nervosa

Published online by Cambridge University Press:  02 January 2018

T. A. Fahy ,
I. Eisler  and
G. F. M. Russell
T. A. Fahy*
Affiliation:
Institute of Psychiatry & King's College Hospital, De Crespigny Park, London SE5 8AZ
I. Eisler
Affiliation:
Institute of Psychiatry
G. F. M. Russell
Affiliation:
Institute of Psychiatry
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

Thirty-nine female out-patients with bulimia nervosa were assessed for personality disorders using the PAS. All subjects then entered a therapeutic trial, comprising eight weeks of cognitive-behavioural therapy with follow-up after eight weeks and at one year. Thirty-nine per cent of the patients were diagnosed as having personality disorders. Patients with personality disorders were more depressed and had a lower BMI than those without. They also had a significantly poorer response to treatment, but the difference between groups did not reach significance when mood and BMI were controlled for. Personality disorder alone does not predict a poor response to treatment, but comorbidity with depression and low weight increases the likelihood of a poor response; these patients are unlikely to respond to brief psychotherapeutic interventions.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 6 , June 1993 , pp. 765 - 770
Copyright
Copyright © The Royal College of Psychiatrists 

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 (1967) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Beck, A. T., Rush, A. J., Shaw, B. F., et al (1979) Cognitive Therapy of Depression. New York: Guilford Press.Google Scholar
Casey, P. R. (1988) The epidemiology of personality disorder. In Personality Disorders: Diagnosis, Management and Course (ed. Tyrer, P. J.), pp. 74–81. London: Wright.Google Scholar
Casey, P. R. (1989) Personality disorder and suicide intent. Acta Psychiatrica Scandinavica, 79, 290–295.Google Scholar
Casey, P. R. & Tyrer, P. J. (1986) Personality, functioning and symptomatology. Journal of Psychiatric Research, 20, 363–374.CrossRefGoogle ScholarPubMed
de Silva, P. & Eysenck, S. (1987) Personality and addictiveness in anorexic and bulimic patients. Personality and Individual Differences, 8, 749–751.Google Scholar
Fahy, T. A., Eisler, I. & Russell, G. F. M. (1993) A placebo-controlled treatment trial of d-fenfluramine in bulimia nervosa. British Journal of Psychiatry, 162, 597–603.Google Scholar
Fairburn, C. (1985) Cognitive behavioural treatment for bulimia. In Handbook of Psychotherapy for Anorexia Nervosa and Bulimia (eds Garner, D. M. & Garfinkel, P. E.), pp. 160–192. New York: Guilford Press.Google Scholar
Garner, D. M. & Garfinkel, P. E. (1979) The eating attitudes test: an index of the symptoms of anorexia nervosa. Psychological Medicine, 9, 273–279.Google Scholar
Griggs, S. M. & Tyrer, P. J. (1981) Personality disorder, social adjustment and treatment outcome in alcoholics. Journal of Studies of Alcohol, 42, 802–805.Google Scholar
Gwirtsman, H. E., Roy-Byrne, P., Yager, J., et al (1983) Neuroendocrine abnormalities in bulimia. American Journal of Psychiatry, 140, 559–563.Google ScholarPubMed
Henderson, M. & Freeman, C. P. L. (1987) A self-rating scale for bulimia. The BITE. British Journal of Psychiatry, 150, 18–24.CrossRefGoogle ScholarPubMed
Hyler, S. E., Rieder, R. O. & Spitzer, R. L. (1982) Personality Diagnostic Questionnaire. New York: New York State Psychiatric Institute.Google Scholar
Johnson, C., Tobin, D. & Dennis, A. (1990) Differences in treatment outcome between borderline and nonborderline bulimics at one-year follow-up. International Journal of Eating Disorders, 9, 617–627.Google Scholar
Levin, A. P. & Hyler, S. E. (1986) DSM-III personality diagnosis in bulimia. Comprehensive Psychiatry, 27, 47–53.Google Scholar
Maddocks, E. & Kaplan, A. S. (1991) The prediction of treatment response in bulimia nervosa. A study of patient variables. British Journal of Psychiatry, 159, 846–849.CrossRefGoogle ScholarPubMed
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Norman, D. K. & Herzog, D. B. (1983) Bulimia, anorexia nervosa, and anorexia nervosa with bulimia. A comparative analysis of MMPI profiles. International Journal of Eating Disorders, 2, 43–52.Google Scholar
Pope, H. G. & Hudson, J. I. (1989) Are eating disorders associated with borderline personality disorder? A critical review. International Journal of Eating Disorders, 8, 1–9.Google Scholar
Reich, J. H. & Green, A. I. (1991) Effect of personality disorders on outcome of treatment. Journal of Nervous and Mental Disease, 179, 74–82.CrossRefGoogle ScholarPubMed
Strober, M. (1981) A comparative analysis of personality organization in juvenile anorexia nervosa. Journal of Youth and Adolescence, 10, 285–295.CrossRefGoogle ScholarPubMed
Swift, W. J. & Wonderlich, S. A. (1988) Personality factors in eating disorders: traits, disorders and structures. In Diagnostic Issues in Anorexia Nervosa and Bulimia Nervosa (eds Garner, D. M. & Garfinkel, P. E.), pp. 112–165. New York: Brunner/Mazel.Google Scholar
Tyrer, P. J. (1988) Personality Disorders: Diagnosis, Management and Course. London: Wright.Google Scholar
Tyrer, P. J. & Alexander, J. (1979) Classification of personality disorder. British Journal of Psychiatry, 135, 163–167.Google Scholar
Tyrer, P. J., Casey, P. & Gall, J. (1983) Relationship between neurosis and personality disorder. British Journal of Psychiatry, 142, 404–408.Google Scholar
Wonderlich, S. A., Swift, W. J., Slotnick, H. B., et al (1990) DSM-III-R personality disorders in eating-disorder subtypes. International Journal of Eating Disorders, 9, 607–616.Google Scholar
World Health Organization (1992) The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: WHO.Google Scholar
Yager, J., Landsverk, J., Edelstein, C. K., et al (1989) Screening for axis II personality disorders in women with bulimic eating disorders. Psychosomatics, 30, 255–262.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.