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Eur Eat Disord Rev. 2013 Mar;21(2):121-9. doi: 10.1002/erv.2182. Epub 2012 Jun 20.

Depression and drive for thinness are associated with persistent bulimia nervosa in the community.

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  • 1Department of Public Health, The Hjelt Institute, University of Helsinki, Helsinki, Finland. anna.keski-rahkonen@helsinki.fi

Abstract

OBJECTIVE:

To examine psychiatric comorbidity and factors that influence the outcome of bulimia nervosa (BN) in the general population.

METHOD:

Women from the nationwide birth cohorts of Finnish twins were screened for lifetime BN (N = 59) by using questionnaires and the Structured Clinical Interview for DSM-IV. We assessed psychiatric comorbidity and other prognostic factors.

RESULTS:

Among women with lifetime BN, the following were more common than among unaffected women: current major depressive disorder (p = 0.004), lifetime major depressive disorder (p = 0.00001) and heavy drinking (p = 0.01). Decreased likelihood of recovery was associated with a history of lifetime major depressive disorder (hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.23-0.84) and high drive for thinness at time of assessment (HR 0.96, 95% CI 0.93-0.99).

DISCUSSION:

Heavy drinking and depression present challenges for many women with BN. Major depressive disorder emerged as the only statistically significant prognostic factor of BN in this nationwide cohort; high drive for thinness was characteristic of the persistently ill.

Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.

PMID:
22715021
[PubMed - indexed for MEDLINE]
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