ANOREXIA-NERVOSA AND BULIMIA-NERVOSA IN ADOLESCENCE - EFFECTS OF AGE AND MENSTRUAL STATUS ON PSYCHOLOGICAL VARIABLES

Objective: To compare, in adolescents and adults with anorexia nervosa and bulimia nervosa, eating disorder symptomatology and comorbid affe ctive and anxiety states. Method: Two hundred fifty consecutive, femal e inpatients on an eating disorders unit were studied. They were given the Beck Depression Inventory; the Depression, Obsessive-Compulsive, Anxiety, and Phobic Anxiety scales from the Symptom Checklist 90; and the Eating Disorder Inventory. Patients were divided into categories b ased on age, diagnosis, and menstrual status. Results: Onset of anorex ia nervosa before age 14 and primary amenorrhea were associated with t he greatest maturity fears during acute illness. For patients with res tricting anorexia, adolescents aged 17 through 19 years had the highes t drive for thinness compared to adolescents aged 13 through 16 years and adults. The lowest levels of depression and anxiety were seen in p atients younger than age 14 with restricting anorexia. Conclusion: Ove rall, few psychological differences between adults and adolescents wit h eating disorders were found, with the exceptions of the youngest res tricting anorectic patients at the time of treatment and both restrict ing and bulimic-anorectic patients who had a very early onset of their illness. Younger patients with acute anorexia nervosa may not require pharmacotherapy for anxiety and depression and may benefit from a foc us on maturity fears in psychotherapy.