Abstract
BackgroundDifferentiation between purging type (AN-P) and restricting type (AN-R) is common in anorexia nervosa (AN) and relevant for clinical practice. However, differences of personality pathology in eating disorders (ED) and their subtypes, which can be captured by the operationalized psychodynamic diagnosis (OPD) system, have not been systematically investigated to date.ObjectivesThe aim of this study was to explore differences in personality structure between the subtypes of AN and bulimia nervosa (BN) using the OPD structure questionnaire (OPD-SQ). In addition, the ability of the instrument to support the classification of eating disorders was examined.Materials and MethodsWe conducted a retrospective, exploratory study in a subset sample of a larger validation study. The OPD-SQ had been collected from n = 60 patients with AN or BN. Patients were assigned to the ED groups by clinical assessment. Statistical analyses included multivariate analysis of variance (MANOVA) and discriminant analysis.ResultsDifferences between ED groups were observed on 5 OPD-SQ main scales and 9 subscales, as well as on the global scale. AN-P patients demonstrated the lowest personality structure on most of the main scales and subscales, whereas AN-R patients showed a higher personality structure level as compared to both BN and AN-P patients. The OPD-SQ scales with the largest differences include self-perception, object perception, and attachment to internal objects. Discriminant analysis resulted in satisfactory assignment to ED groups by OPD-SQ subscales.ConclusionsPersonality structure was found to be less developed in patients with BN and AN-P as compared to patients with AN-R. Although the results have to be proven in larger prospective studies, these results suggest that the OPD-SQ may be used to support the clinical assessment and classification in patients with EDs.
Highlights
Treatment of eating disorders (ED) such as anorexia nervosa (AN) and bulimia nervosa (BN) is challenging (Vall and Wade, 2015)
Patients were assigned to BN, AN-R, and AN-P groups using International Classification of Diseases (ICD)-10 criteria
N = 60 patients with complete datasets were included for analyses
Summary
Treatment of eating disorders (ED) such as anorexia nervosa (AN) and bulimia nervosa (BN) is challenging (Vall and Wade, 2015). “Sub-threshold” disturbance in personality functioning or manifest personality disorders (PD) are frequent comorbidities (Martinussen et al, 2017), which contribute to the difficulties during treatment and may support the persistence of the ED in some patients (Farstad et al, 2016). There is still a lack of empirical research about the extent of personality functioning across different types of EDs and especially the comparison of those between different EDs. Differentiation between purging type (AN-P) and restricting type (AN-R) is common in anorexia nervosa (AN) and relevant for clinical practice. Differences of personality pathology in eating disorders (ED) and their subtypes, which can be captured by the operationalized psychodynamic diagnosis (OPD) system, have not been systematically investigated to date
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