CLUSTER-B PERSONALITY-DISORDER CHARACTERISTICS PREDICT OUTCOME IN THETREATMENT OF BULIMIA-NERVOSA

The Personality Disorders Examination (PDE) was administered to 71 bul imia nervosa patients at baseline assessment in a study comparing the effectiveness of cognitive-behavioral treatment with desipramine or th e combination of both treatments. Personality disorder subscales were combined into single DSM-III-R cluster scores. A high cluster B score (consisting of antisocial, borderline, histrionic, and narcissistic fe atures) significantly predicted poor outcome at 16 weeks and was a bet ter predictor of outcome than borderline personality characteristics a lone or any other DSM-III-R cluster score or combination of cluster sc ores. In contrast pretreatment depression level, self-esteem, degree o f dietary restraint, frequency of purging, and history of anorexia ner vosa were not significantly related to outcome. At 1-year follow-up th ere was still a trend toward high cluster B scores predicting poor tre atment outcome. Cluster B score was not significantly correlated with percentage of sessions attended nor did subjects with higher cluster B scores have a better outcome with either specific treatment. These re sults suggest that further investigation of alternative treatments is warranted with high cluster B individuals to determine if treatment ef fectiveness can be improved.