Differences between adolescent patients with anorexia and bulimia nervosa with reference to psychological and psychosocial markers

Abstract

We present a retrospective study of 140 patients (110 with anorexia nervosa, 30 with bulimia nervosa), hospitalized between 1982-1992 at the Department of Child and Adolescent Psychiatry at the University of Wuerzburg, Germany. All patients met the ICD-10 criteria for anorexia nervosa or bulimia nervosa. We collected data from basic documentation and the multiaxial classification (MAS), using a variety of standard instruments such as Anis 32, MMPI, BDI, HAWIK-R and HAWIE. Our findings show significant differences between the two populations. At the time of their first admission anorectic patients were somewhat younger than their bulimic counterparts (14.5 years vs. 16.5 years, respectively). With regard to the typical symptoms of either disorder, the two populations differ in their eating behavior on the factor bulimia described by Anis-32. A comparison of personality features reveals that anorectic patients scored lower than bulimic patients on the MMPI scales, especially on psychopathology, but higher on depression in the BDI. Other characteristics of anorectic patients include a higher-than-average IQ, more enmeshment and overprotectiveness in family relations, more separation anxiety and insufficient communication skills at school. By contrast, bulimic patients demonstrated poorer scholastic performance and more discipline problems at school, while communication among family members was impaired.