The role of depression and impulsivity in the psychopathology of bulimia nervosa

Abstract

Introduction: The study aimed to analyze the role of depression and impulsivity in the psychopathology of bulimia nervosa (BN).

Materials and methods: Seventy female patients with DSM-IV BN, purging subtype, were assessed for eating-related symptoms, body dissatisfaction, affective symptoms, impulsivity, and personality traits. Factor analysis and structural equation modeling methods were used for statistical analysis.

Results: BN appeared as a condition which incorporated 5 general dimensions: a) binge eating and compensatory behaviours; b) restrictive eating; c) body dissatisfaction; d) dissocial personality traits; and e) a cluster of features which was called «emotional instability» The 5 obtained dimensions can be grouped into 2 basic factors: body dissatisfaction/eating behaviour and personality traits/psychopathology. The first one contains the clinical items used for the definition of BN as a clinical condition in the DSM-V and the International Classification of Diseases 10, and reflects the morphology and the severity of the eating-related symptoms. The second dimension includes a cluster of symptoms (depressive symptoms, impulsivity, and borderline, self-defeating and dissocial personality traits) which could be regarded as the «psychopathological core» of BN and may be able to condition the course and the prognosis of BN.

Keywords: Borderline personality; Bulimia nerviosa; Bulimia nervosa; Depresión; Depression; Impulsividad; Impulsivity; Personalidad autodestructiva; Personalidad borderline; Self-defeating personality.