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. 2003 Nov;34(3):319-30.
doi: 10.1002/eat.10196.

The natural course of bulimia nervosa and eating disorder not otherwise specified is not influenced by personality disorders

Carlos M Grilo  1 , Charles A Sanislow, M Tracie Shea, Andrew E Skodol, Robert L Stout, Maria E Pagano, Shirley Yen, Thomas H McGlashan
Affiliations

The natural course of bulimia nervosa and eating disorder not otherwise specified is not influenced by personality disorders

Carlos M Grilo et al. Int J Eat Disord. 2003 Nov.

Abstract

Objective: To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) and to test the effects of personality disorder (PD) comorbidity on the outcomes.

Method: Ninety-two female patients with current BN (N=23) or EDNOS (N=69) were evaluated at baseline enrollment in the Collaborative Longitudinal Personality Disorders Study (CLPS). Eating disorders (EDs) were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders. Personality disorders (PDs) were assessed with the Diagnostic Interview for DSM-IV PD (DIPD-IV). The course of BN and EDNOS was assessed with the Longitudinal Interval Follow-up Evaluation and the course of PDs was evaluated with the Follow-Along version of the DIPD-IV at 6, 12, and 24 months.

Results: Probability of remission at 24 months was 40% for BN and 59% for EDNOS. To test the effects of PD comorbidity on course, ED patients were divided into groups with no, one, and two or more PDs. Cox proportional regression analyses revealed that BN had a longer time to remission than EDNOS (p<.05). The number of PDs was not a significant predictor of time to remission, nor was the presence of Axis I psychiatric comorbidity or Global Assessment of Functioning scores. Analyses using proportional hazards regression with time-varying covariates revealed that PD instability was unrelated to changes in ED.

Conclusions: BN has a worse 24-month course (longer time to remission) than EDNOS. The natural course of BN and EDNOS is not influenced significantly by the presence, severity, or time-varying changes of co-occurring PDs, co-occurring Axis I disorders, or by global functioning.

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Figures

Figure 1
Figure 1
Time to remission from eating disorder for bulimia (straight line) and eating disorder not otherwise specified (dotted line) for females only.
Figure 2
Figure 2
Time to remission from eating disorders (bulimia or eating disorder not otherwise specified) by number of comorbid personality disorders (PDs). The study included females only. Straight line = no PDs; dotted line = one PD; dashed line = two or more PDs.
See this image and copyright information in PMC

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