THE CHANGING PROFILE OF ANOREXIA-NERVOSA AT THE TORONTO PROGRAM FOR EATING DISORDERS

The present study is a retrospective comparison of anorexic patients o f the restricting subtype (AN) with those of the bulimic subtype (AN+B N) over three consecutive 5-year time periods. Subjects consisted of 8 06 female out-patients diagnosed as either AN or AN+BN between 1978 an d 1994 during an assessment of their eating problem at the University of Toronto Programme for Eating Disorders in Toronto, Canada. During e ach time period an increasing proportion of subjects was diagnosed wit h AN+BN than with AN. Subjects with AN+BN reported a longer duration o f illness prior to being assessed. Over time, subjects in both groups appeared to weigh more, and were less likely to report amenorrhea. Sub jects from both groups reported higher frequencies of purging behavior , impulsive behaviors, and associated affective symptoms in the later time periods. Over time, the differences between the two subgroups of patients became less distinct. The results indicate changes in the cli nical profile of patients with anorexia nervosa seen at the Toronto Pr ogramme for Eating Disorders over the past 16 years. The implications of these changes are explored. (C) 1998 Elsevier Science Inc.