Ego functioning in eating disorders: Description and relation to diagnostic classification

A working assumption for many clinicians is that differences in personality functioning among eating-disordered patients are crucial for treatment planning and prognosis. However, the empirical documentation is scarce. The present study used analyses of 13 objectively rated ego functions in a sample of 48 eating-disordered patients to try to establish a firmer empirical basis in the area. The variation in ego functioning was great, and a cluster analysis identified four clusters. These were tentatively named “higher neurotic,” “lower neurotic,” “borderline,” and “borderline-psychotic.” The clusters were unrelated to DSM-III-R eating disorder diagnoses and to the restricter/bulimic distinction and related markedly differently from those classifications to other clinical variables. The most interesting associations occurred between ego functioning and variables of possible prognostic value. Ego functioning thus constitutes a complementary diagnostic dimension of potential importance for prognosis.