Clinical correlates of personality disorder in bulimia nervosa

Thirty women of normal weight with a DSM-III-R diagnosis of bulimia nervosa who were involved in a drug treatment study were divided into two groups. The division into groups was based on criteria for personality disorder (personality disorder, PD, n = 14; no personality disorder, NPD, n = 16). The groups were assessed on cognitive, psychological, psychiatric, and physiological measures. Compared with the NPD group, the PD group was significantly more likely to have a history of major depression and suicide attempts. The PD group had higher lifetime maximum and minimum body mass indices. Eating Disorder inventory (EDI) total score was significantly higher (more severe) among the PD group. EDI subscales Drive for Thinness, Body Dissatisfaction, Ineffectiveness, and Personal Distress were significantly elevated for the PD group. These findings support cognitive, psychological, psychiatric, and physiological differences between bulimics with and without personality disorder.