Impact of borderline personality disorder on bulimia nervosa

Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
Australian and New Zealand Journal of Psychiatry (Impact Factor: 3.41). 01/2009; 42(12):1021-9. DOI: 10.1080/00048670802512040
Source: PubMed


The primary aim of the present study was to examine whether the presence of borderline personality disorder (BPD) adversely impacted on outcome 3 years after treatment among women with bulimia nervosa (BN), in comparison to those women with either other personality disorders (other PD) or no personality disorder (no PD).
Participants were 134 women who received cognitive behaviour therapy for BN. The sample was divided into three groups: BPD (n=38), other PD (n=37), and no PD (n=59). Eating disorder (ED) symptoms and attitudes, and personality traits were examined at pretreatment assessment, 1 year and 3 year follow up.
At pretreatment assessment the BPD group had higher purging frequency, more comorbidity and poorer general functioning than the other PD and no PD groups. By 3 year follow up, however, no significant differences were found in ED symptomatology and general functioning among the groups. Pretreatment differences between the BPD and no PD groups on the personality measures of harm avoidance, self-directedness and cooperativeness disappeared over the course of 3 years.
Although women with BN and comorbid BPD appear more impaired at pretreatment assessment, they do not have poorer outcome than the other PD and no PD groups. The rate and level of improvement across the groups is not affected by the presence of BPD.

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Available from: Sarah Rowe, Dec 22, 2014
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    • "Past u daarvoor op, want u doet uw patiënt tekort. Zelfs de as-II klachten worden minder ernstig (ervaren) door uw patiënt nadat zij is behandeld voor de as-I problematiek (Rø et al., 2005a, 2005b; Rowe et al., 2008). Een evaluatie aan het begin (na 5 sessies bijvoorbeeld) en het eind van de behandeling is echter raadzaam. "

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    • "Mixed findings exist on the impact of personality pathology on eating disorder treatment outcome, with some studies reporting greater binge eating severity [19] and more disturbed psychiatric symptoms posttreatment in those with personality pathology [14] [20]. In contrast, other studies report that the presence of a PD did not predict outcome [21] [22] [23]. "
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    ABSTRACT: Recent research has suggested a move toward a dimensional system for the classification of personality disorders (PDs). Tyrer's dimensional model using severity as a form of categorizing PDs was used to compare eating disorder outcome in women with bulimia nervosa (BN) over 3 years. One hundred thirty-four women with BN were divided into 4 groups based on PD severity: no PD (n = 32), personality difficulty (n = 27), simple PD (n = 29), and complex PD (n = 46). Eating disorder symptoms and attitudes, general psychosocial functioning, and depressive symptoms were examined at pretreatment and at 1-year and 3-year follow-up (posttreatment). The complex PD group had greater Axis I comorbidity and psychopathology than the remaining 3 groups at pretreatment. At 1-year and 3-year follow-up, there were no differences in eating disorder outcome, general psychosocial functioning, and depressive symptoms across the 4 groups. These results suggest that having an increased number of PDs comorbid with BN does not influence eating disorder outcome up to 3 years after treatment.
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    ABSTRACT: To examine the impact of avoidant personality disorder (AVPD) on bulimia nervosa (BN) treatment outcome over 3 years. Women with BN were participating in a randomized treatment trial. The sample was split into: AVPD (n = 37), other PD (n = 37), and no PD (n = 60). Eating disorder symptomatology, depressive symptoms and psychosocial functioning were examined at pretreatment and follow-up. Multiple regression was conducted to control for high axis I comorbidity. There were no significant differences across the groups at pretreatment or follow-up on eating disorder symptoms. AVPD had worse depressive symptoms and psychosocial functioning at pretreatment which continued 3 years post-treatment. Multiple regression analyses revealed that the presence of any lifetime mood disorder contributed to these significant results. These findings suggest AVPD is not a significant predictor of BN outcome. However, AVPD is associated with poorer psychiatric symptoms although much of this variance appears to be attributable to the lifetime presence of any mood disorder. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010
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