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Co-morbidity and disorder-related distress and impairment in purging disorder

Published online by Cambridge University Press:  10 September 2007

P. K. Keel ,
B. E. Wolfe ,
J. A. Gravener  and
D. C. Jimerson
P. K. Keel*
Affiliation:
Department of Psychology, The University of Iowa, Iowa City, IA, USA
B. E. Wolfe
Affiliation:
Psychiatric/Mental Health Department, Connell School of Nursing, Boston College, Boston, MA, USA
J. A. Gravener
Affiliation:
Department of Psychology, The University of Iowa, Iowa City, IA, USA
D. C. Jimerson
Affiliation:
Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: P. K. Keel, Ph.D., E11 Seashore Hall, Iowa City, IA 52246, USA. (Email: pamela-keel@uiowa.edu)
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Abstract

Background

Recent studies suggest that purging disorder (PD) may be a common eating disorder that is associated with clinically significant levels of distress and high levels of psychiatric co-morbidity. However, no study has established evidence of disorder-related impairment or whether distress is specifically related to PD rather than to co-morbid disorders.

Method

Three groups of normal-weight women [non-eating disorder controls (n=38), with PD (n=24), and with bulimia nervosa (BN)-purging subtype (n=57)] completed structured clinical interviews and self-report assessments.

Results

Both PD and BN were associated with significant co-morbidity and elevations on indicators of distress and impairment compared to controls. Compared to BN, PD was associated with lower rates of current and lifetime mood disorders but higher rates of current anxiety disorders. Elevated distress and impairment were maintained in PD and BN after controlling for Axis I and Axis II disorders.

Conclusions

PD is associated with elevated distress and impairment and should be considered for inclusion as a provisional disorder in nosological schemes such as the Diagnostic and Statistical Manual to facilitate much-needed research on this clinically significant syndrome.

Keywords

Co-morbiditydistressimpairmentnosologypurging
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 10 , October 2008 , pp. 1435 - 1442
Copyright
Copyright © 2007 Cambridge University Press

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