SEXUAL ABUSE AND BULIMIA-NERVOSA - 3 INTEGRATED CASE-CONTROL COMPARISONS

Objective: This study has three aims: to determine whether sexual abus e increases the risk of developing bulimia nervosa, to see whether any increase in risk is specific to bulimia nervosa, and to determine whe ther patients referred for treatment of bulimia nervosa differ from a community group of subjects with bulimia nervosa with respect to their exposure to sexual abuse. Method: A case control design with individu al matching was used. There were three related case control comparison s. Fifty community-based subjects with bulimia nervosa were compared w ith 100 community-based comparison subjects without an eating disorder , 50 community-based comparison subjects with other psychiatric disord ers, and 50 patients (secondary referrals) with bulimia nervosa. An in vestigator-based interview was used to assess sexual abuse. Results: s exual abuse involving physical contact was reported by a minority of t he community-based subjects with bulimia nervosa. It was more common a mong this group than among the normal comparison subjects. There was n o difference between the community-based subjects with bulimia nervosa and either the subjects with general psychiatric disorders or the pat ients with bulimia nervosa. Conclusions: While the findings indicate t hat sexual abuse is a risk factor for the development of bulimia nervo sa, it does not appear to be specific to bulimia nervosa nor is it rel evant to most cases. Sexual abuse appears to be a risk factor for psyc hiatric disorder in general (including bulimia nervosa) among young ad ult women. There was no evidence that secondary referrals of bulimia n ervosa are biased with respect to sexual abuse.