Psychiatric history and perceptions of family of origin in women with binge eating disorder

Abstract

The eating disorder Binge Eating Disorder (BED) is closely related to Bulimia Nervosa (BN), the essential difference being the absence of purging behaviours in BED. There is accumulating evidence that BED is a relatively common disorder, and is associated with elevated rates of other psychopathology. Yet there is poor provision for classifying individuals with BED in the existing psychiatric nomenclature.

Much existing research on BED uses subjects in treatment for obesity, and most community. studies have used questionnaires to diagnose BED. Thus there exists an urgent need for studies using community samples, that utilise reliable clinical interviews.

In the present controlled community study, rates of psychiatric disorders in 20 women who fulfilled DSM-IV research criteria for BED were investigated, using a structured diagnostic interview. Subjects' childhood family environments were also examined. The existing literature suggests that women with BN experienced more dysfunctional family environments during childhood, compared both to controls and to women with Anorexia Nervosa. It was thus an interesting empirical question whether women with BED would also describe their childhood family environments as more dysfunctional than controls.

In the present study women with BED were found to have significantly higher lifetime rates of affective and anxiety disorders. Of interest was the high rates of major depression found in both the BED and control groups in this study. Possible factors accounting for this finding are discussed. In addition, BED was more frequently reported present in the first degree relatives of BED probands. Furthermore, women with BED tended to perceive both their parents as having been significantly less caring and more controlling, and described their childhood family environments more negatively, compared to controls. Finally, women with BED reported significantly lower levels of self-esteem. These results, and the relationship between BED and the non-purging subtype of BN, are discussed with reference to the literature.