THE SIGNIFICANCE OF A PRIOR HISTORY OF ANOREXIA IN BULIMIA-NERVOSA

Objective: Some authors stratify women with current, normal-weight bul imia nervosa into groups defined by the presence or absence of a past history of anorexia nervosa. Unlike the distinction between current an orexia nervosa with or without bulimic symptoms, fewer studies have in vestigated the significance of stratifying bulimic women by a past his tory of anorexia. Method: One hundred and fourteen women with bulimia nervosa in a clinical trial were studied via structured clinical inter views covering Axis I and II disorders and measures of personality and symptomatology. Prospective, 14-day dietary analysis was available fo r a subset of subjects. Results: Bulimic women with a past history of anorexia nervosa were significantly more likely to have a lifetime anx iety disorder, lower current body mass index, increased cooperativenes s on the Temperament and Character Inventory, and increased mature and neurotic scores on the Defense Style Questionnaire. These women also reported lower scores on the bulimia subscale of the Eating Disorders Inventory, but these self-report data were not consistent with the num bers of objective binges or reported energy intake. The prevalence of other Axis I disorders, Axis II personality disorders, and bulimic sym ptomatology was quite similar across groups. Conclusions: Although bul imic women with a prior history of anorexia nervosa differed in limite d respects from those without such a history, the differences were out weighed by the similarities. A past history of anorexia nervosa did no t appear to define particularly meaningful subgroups of women with cur rent, normal-weight bulimia nervosa. (C) 1996 by John Wiley & Sons, In c.