Psychological features in male and female adolescents with eating disorders: is it the same condition?

Abstract

Purpose: Eating disorders (EDs) are psychiatric disorders with a typical prevalence in adolescence. EDs have long been wrongly considered female gender-bound disorders, resulting in a systematic underrepresentation of males in EDs research. The main goal of the present study is exploring the clinical and psychological characteristics of adolescent males with EDs in comparison with females.

Methods: In this observational and retrospective study, 14 males and 28 females hospitalized for eating disorders during the adolescent age (from 12 to 17.11 years) were recruited. Main clinical data (age, BMI, duration of illness), behavioural characteristic of the disorder (over-exercising, self-harm, purging-behaviours) and psychological symptoms (Eating Disorders Inventory-3rd edition-EDI-3, Symptom Checklist-90-Revised-SCL-90, Children's Global Assessment Scale-C-GAS) were collected and examined for significant correlations with severity of body mass index (BMI).

Results: Adolescent males show a peculiar and more severe psychopathological profiles partially influenced by BMI and characterized by purging-behaviours, over-exercising, obsessive-compulsive behaviour, anxiety, and psychoticism.

Conclusion: This study suggests a gender-specific profile of adolescent males with EDs, which may be considered in diagnosis and treatment.

Level iii: Evidence obtained from retrospective well-designed case-control study.

Keywords: Adolescent male; Anorexia nervosa; Bulimia; Eating disorders; Gender.

Fig. 1

Graphic representation of means of scores at subscales of EDI-3. The asterisks indicate a significant difference between conditions: *p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.005 (Drive for Thinness -DT-, Bulimia -B-, Body Dissatisfaction -BD-, Low Self-Esteem -LSE-, Personal Alienation -PA-, Interpersonal Insecurity -II-, Interpersonal Alienation -IA-, Interoceptive Deficits -ID-, Emotional Dysregulation -ED-, Perfectionism -P-, Asceticism -A-, and Maturity Fears -MF-, Eating Disorder Risk Composite -EDRC-, Ineffectiveness Composite -IC, Interpersonal Problems Composite -IPC, Affective Problems Composite -APC-, Overcontrol Composite -OC-, and General Psychological Maladjustment Composite -GPMC-)

Fig. 2

Graphic representation of means of scores at subscales of SCL90-R. The asterisks indicate a significant difference between conditions: *p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.005 (somatization -SOM-, obsessive–compulsive -OC-, interpersonal sensitivity -INT-, depression DEPR-, anxiety -ANX-, hostility -HOS-, phobic anxiety -PHOB-, paranoid ideation -PAR-, psychoticism -PSY-, General Symptomatic Index -GSI-, Positive Symptom Total -PST-, Positive Symptom Distress Index -PSDI-)