Bulimia nervosa with and without obsessive-compulsive syndromes

The present study was performed in a group of bulimic (BN) females (1) to a ssess prevalence rates of comorbid obsessive-compulsive phenomena; (2) to i nvestigate whether BN patients display a characteristic cluster of obsessiv e-compulsive symptoms; and (3) to determine whether obsessive-compulsive sy mptoms influence the clinical picture of BN. Thirty-eight DSM-IV BN females were interviewed by means of the Structured Clinical Interview for DSM-III -R (SCID) to assess the prevalence rate of obsessive compulsive disorder (O CD); the Yale-Brown Obsessive-Compulsive Symptom Scale (Y-BOCS) Symptom Che ck-List was also used to evaluate the presence of obsessive-compulsive symp toms. The phenomenology of BN females with obsessive-compulsive syndromes ( OCS) as detected by the Y-BOCS was compared to that shown by a "control" gr oup of nonbulimic OCD females. Finally, the eating-related psychopathology of BN women with and without OCS was compared. The current prevalence rates of OCD and of subthreshold obsessive-compulsive syndrome (sOCS) in our sam ple were 10.5% and 15.8%, respectively. Thus, a total of 26.3% of BN female s had a current OCS that comprised both clinical disorders and subthreshold syndromes, No differences were detected between obsessive-compulsive sympt oms of these females and those of the control group of nonbulimic OCD femal es. BN females with OCS had higher ratings on the Eating Disorder Inventory (EDI) total score and on the "drive for thinness" and the "bulimia" items of the scale, as compared to BN females without OCS. In conclusion, it appe ars that a considerable proportion of BIN females display OCS, which someti mes are not severe enough to fulfill diagnostic criteria for OCD. Moreover, in these patients, obsessive-compulsive symptoms are undistinguishable fro m those of OCD females, and exert a negative influence on the clinical pict ure of the bulimic disorder. Copyright (C) 2001 by W.B. Saunders Company.