Axis-I comorbidity is linked to prospective instability of diagnoses within eating disorders

BMC Psychiatry

Research Article

Sabina Muehlebach¹  Anja Spindler¹  Gabriella F Milos¹  Volker Baur² 

[1] Centre for Eating Disorders, Department of Psychiatry and Psychotherapy, University Hospital Zurich, Culmannstr. 8, CH-8091, Zurich, Switzerland;Centre for Eating Disorders, Department of Psychiatry and Psychotherapy, University Hospital Zurich, Culmannstr. 8, CH-8091, Zurich, Switzerland;Division Neuropsychology, Institute of Psychology, University of Zurich, Binzmuhlestr 14/25, CH-8050, Zurich, Switzerland;

关键词: Eating disorders;    Anorexia Nervosa;    Bulimia Nervosa;    Comorbidity;    Diagnostic instability;    Affective disorder;   

DOI  :  10.1186/1471-244X-13-295

 received in 2013-04-05, accepted in 2013-08-21,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundEating disorders (ED) are classified into Anorexia Nervosa, Bulimia Nervosa, and eating disorder not otherwise specified. Prospectively, the diagnostic instability within ED is high, but it is not clear which factors may account for this instability. So far, there is no evidence of whether psychiatric comorbidity may play a role in ED diagnostic crossover. We sought to determine possible influences of comorbidities of axis I and II on diagnostic crossover within ED.MethodsLongitudinal data of 192 female patients were collected. All patients had a diagnosis of a current ED at study entry (baseline, T0). Diagnoses were re-established both 12 months (T1) and 30 months (T2) after T0. Comorbid psychiatric diagnoses were grouped into axis I and axis II according to DSM-IV.ResultsPatients with instable ED diagnoses had lifetime axis-I comorbidity more frequently than patients with stable ED diagnoses (χ2 = 4.74, df = 1, p < 0.05). Post-hoc exploratory tests suggested that the effect was mainly driven by affective disorders like major depression. There was no difference for axis-II comorbidity between stable and instable diagnostic profiles.ConclusionsFollowing previous reports of diagnostic crossover in ED, the present investigation points to an influence of a life-time psychiatric comorbidity, in particular of axis I, on follow-up diagnoses of ED. Comorbid affective disorders like major depression might facilitate a switching between clinical phenotypes. The understanding of mechanisms and causes of the symptoms fluctuation will be subject of future studies.

【 授权许可】

CC BY   
© Milos et al.; licensee BioMed Central Ltd. 2013