Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa

Hiroki Nishimura, Gen Komaki, Tetsuya Ando, Toshihiro Nakahara, Takakazu Oka, Keisuke Kawai, Toshihiko Nagata, Aya Nishizono, Yuri Okamoto, Kenjiro Okabe, Masanori Koide, Chikara Yamaguchi, Satoshi Saito, Kazuyoshi Ohkuma, Katsutaro Nagata, Tetsuro Naruo, Masato Takii, Nobuo Kiriike, Toshio Ishikawa

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Patients with anorexia nervosa-restricting type (AN-R) sometimes develop accompanying bulimic symptoms or the full syndrome of bulimia nervosa (BN). If clinicians could predict who might change into the bulimic sub-type or BN, preventative steps could be taken. Therefore, we investigated anthropometric and psychological factors possibly associated with such changes. Method: All participants were from a study by the Japanese Genetic Research Group for Eating Disorders. Of 80 patients initially diagnosed with AN-R, 22 changed to the AN-Binge Eating/Purging Type (AN-BP) and 14 to BN for some period of time. The remaining 44 patients remained AN-R only from the onset to the investigation period. Variables compared by ANOVA included anthropometric measures, personality traits such as Multiple Perfectionism Scale scores and Temperament and Character Inventory scores, and Beck Depression Inventory-II scores. Results: In comparison with AN-R only patients, those who developed BN had significantly higher current BMI (p < 0.05) and maximum BMI in the past (p < 0.05). They also scored significantly higher for the psychological characteristic of parental criticism (p < 0.05) and lower in self-directedness (p < 0.05), which confirms previous reports, but these differences disappeared when the depression score was used as a co-variant. No significant differences were obtained for personality traits or depression among the AN-R only patients irrespective of their duration of illness. Conclusion: The present findings suggest a tendency toward obesity among patients who cross over from AN-R to BN. Low self-directedness and high parental criticism may be associated with the development of BN by patients with AN-R, although the differences may also be associated with depression.

Original languageEnglish
Article number5
JournalBioPsychoSocial Medicine
Volume2
DOIs
Publication statusPublished - Feb 12 2008
Externally publishedYes

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Bulimia Nervosa
Anorexia Nervosa
Psychology
Weights and Measures
Depression
Personality
Equipment and Supplies
Genetic Research
Bulimia
Temperament
Analysis of Variance
Obesity

ASJC Scopus subject areas

  • Social Psychology
  • Psychology(all)
  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa. / Nishimura, Hiroki; Komaki, Gen; Ando, Tetsuya; Nakahara, Toshihiro; Oka, Takakazu; Kawai, Keisuke; Nagata, Toshihiko; Nishizono, Aya; Okamoto, Yuri; Okabe, Kenjiro; Koide, Masanori; Yamaguchi, Chikara; Saito, Satoshi; Ohkuma, Kazuyoshi; Nagata, Katsutaro; Naruo, Tetsuro; Takii, Masato; Kiriike, Nobuo; Ishikawa, Toshio.

In: BioPsychoSocial Medicine, Vol. 2, 5, 12.02.2008.

Research output: Contribution to journalArticle

Nishimura, H, Komaki, G, Ando, T, Nakahara, T, Oka, T, Kawai, K, Nagata, T, Nishizono, A, Okamoto, Y, Okabe, K, Koide, M, Yamaguchi, C, Saito, S, Ohkuma, K, Nagata, K, Naruo, T, Takii, M, Kiriike, N & Ishikawa, T 2008, 'Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa', BioPsychoSocial Medicine, vol. 2, 5. https://doi.org/10.1186/1751-0759-2-5
Nishimura, Hiroki ; Komaki, Gen ; Ando, Tetsuya ; Nakahara, Toshihiro ; Oka, Takakazu ; Kawai, Keisuke ; Nagata, Toshihiko ; Nishizono, Aya ; Okamoto, Yuri ; Okabe, Kenjiro ; Koide, Masanori ; Yamaguchi, Chikara ; Saito, Satoshi ; Ohkuma, Kazuyoshi ; Nagata, Katsutaro ; Naruo, Tetsuro ; Takii, Masato ; Kiriike, Nobuo ; Ishikawa, Toshio. / Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa. In: BioPsychoSocial Medicine. 2008 ; Vol. 2.
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T1 - Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa

AU - Nishimura, Hiroki

AU - Komaki, Gen

AU - Ando, Tetsuya

AU - Nakahara, Toshihiro

AU - Oka, Takakazu

AU - Kawai, Keisuke

AU - Nagata, Toshihiko

AU - Nishizono, Aya

AU - Okamoto, Yuri

AU - Okabe, Kenjiro

AU - Koide, Masanori

AU - Yamaguchi, Chikara

AU - Saito, Satoshi

AU - Ohkuma, Kazuyoshi

AU - Nagata, Katsutaro

AU - Naruo, Tetsuro

AU - Takii, Masato

AU - Kiriike, Nobuo

AU - Ishikawa, Toshio

PY - 2008/2/12

Y1 - 2008/2/12

N2 - Background: Patients with anorexia nervosa-restricting type (AN-R) sometimes develop accompanying bulimic symptoms or the full syndrome of bulimia nervosa (BN). If clinicians could predict who might change into the bulimic sub-type or BN, preventative steps could be taken. Therefore, we investigated anthropometric and psychological factors possibly associated with such changes. Method: All participants were from a study by the Japanese Genetic Research Group for Eating Disorders. Of 80 patients initially diagnosed with AN-R, 22 changed to the AN-Binge Eating/Purging Type (AN-BP) and 14 to BN for some period of time. The remaining 44 patients remained AN-R only from the onset to the investigation period. Variables compared by ANOVA included anthropometric measures, personality traits such as Multiple Perfectionism Scale scores and Temperament and Character Inventory scores, and Beck Depression Inventory-II scores. Results: In comparison with AN-R only patients, those who developed BN had significantly higher current BMI (p < 0.05) and maximum BMI in the past (p < 0.05). They also scored significantly higher for the psychological characteristic of parental criticism (p < 0.05) and lower in self-directedness (p < 0.05), which confirms previous reports, but these differences disappeared when the depression score was used as a co-variant. No significant differences were obtained for personality traits or depression among the AN-R only patients irrespective of their duration of illness. Conclusion: The present findings suggest a tendency toward obesity among patients who cross over from AN-R to BN. Low self-directedness and high parental criticism may be associated with the development of BN by patients with AN-R, although the differences may also be associated with depression.

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