LIFETIME ANXIETY DISORDERS IN WOMEN WITH BULIMIA-NERVOSA

We examined the prevalence and ages at onset of additional childhood a nd adult psychiatric disorders in women with bulimia nervosa and evalu ated the differential impact of a mood or anxiety disorder on the pres entation of bulimia nervosa. One hundred fourteen women participating in a clinical trial of cognitive-behavioral therapy for bulimia nervos a were assessed at pretreatment with structured diagnostic methodology . Although mood disorders were the most frequently occurring additiona l psychiatric disorder (75%), 64% experienced an additional anxiety di sorder. Age at onset of the anxiety disorders was markedly earlier tha n age at onset of bulimia nervosa or other comorbid conditions. Strati fication of the sample on the presence of a mood or anxiety disorder r evealed no differences in the core bulimic symptoms across groups. The presence of a mood disorder was associated with greater body dissatis faction, lower Global Assessment of Functioning Scales (GAFS) score, m ore externalizing disorders of childhood, and, as expected, higher Ham ilton Depression Rating Scale (HDRS) scores. The presence of an anxiet y disorder was related to a history of anorexia nervosa and earlier ag e at onset of drug or alcohol dependence. Early-onset anxiety disorder s are prevalent and may represent one potential pathway to bulimia ner vosa. Copyright (C) 1996 by W.B. Saunders Company.