COMORBIDITY OF AXIS-I PSYCHIATRIC-DISORDERS IN BULIMIA-NERVOSA

Background: The coexistence of other psychiatric disorders in patients with bulimia nervosa is of major clinical and theoretical interest. W e therefore studied a group of consecutively evaluated bulimic patient s. Method: The Structured Clinical Interview for DSM-III-R (SCID) was administered to a sample of 59 female patients with DSM-III-R-defined bulimia nervosa. Results: The following frequencies of lifetime Axis I comorbid diagnoses were found (in decreasing frequency): any affectiv e disorder (75%), major depressive disorder (63%), any anxiety disorde r (36%), any substance abuse disorder (20%), social phobia (17%), gene ralized anxiety disorder (12%), and panic disorder (10%). In the 44 ca ses with an affective disorder, 27 (61%) had the onset of their affect ive disorder prior to the onset of their bulimia, 15 (34%) afterward, and 2 (5%) concurrently. In the 21 cases with any anxiety disorder, 15 (71%) had the onset of their anxiety disorder prior to the onset of t heir bulimia, 4 (19%) afterward, and 2 (10%) concurrently. Conclusion: These data confirm previous reports of a strong association between b ulimia nervosa and affective illness, which in most cases precedes the eating disorder. In addition, a high frequency of anxiety disorders, particularly social phobia, is seen in bulimic patients.