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Depression and Drive for Thinness are Associated with Persistent Bulimia Nervosa in the Community
Author(s) -
KeskiRahkonen Anna,
Raevuori Anu,
Bulik Cynthia M.,
Hoek Hans W.,
Sihvola Elina,
Kaprio Jaakko,
Rissanen Aila
Publication year - 2013
Publication title -
european eating disorders review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.511
H-Index - 67
eISSN - 1099-0968
pISSN - 1072-4133
DOI - 10.1002/erv.2182
Subject(s) - eating disorders , bulimia nervosa , comorbidity , depression (economics) , hazard ratio , psychiatry , major depressive disorder , psychology , cohort , population , confidence interval , cohort study , risk factor , clinical psychology , medicine , cognition , environmental health , economics , macroeconomics
Objective To examine psychiatric comorbidity and factors that influence the outcome of bulimia nervosa (BN) in the general population. Method Women from the nationwide birth cohorts of Finnish twins were screened for lifetime BN ( N = 59) by using questionnaires and the Structured Clinical Interview for DSM‐IV. We assessed psychiatric comorbidity and other prognostic factors. Results Among women with lifetime BN, the following were more common than among unaffected women: current major depressive disorder ( p = 0.004), lifetime major depressive disorder ( p = 0.00001) and heavy drinking ( p = 0.01). Decreased likelihood of recovery was associated with a history of lifetime major depressive disorder (hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.23–0.84) and high drive for thinness at time of assessment (HR 0.96, 95% CI 0.93–0.99). Discussion Heavy drinking and depression present challenges for many women with BN. Major depressive disorder emerged as the only statistically significant prognostic factor of BN in this nationwide cohort; high drive for thinness was characteristic of the persistently ill. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.