Symptom fluctuation in eating disorders: correlates of diagnostic crossover.

  title={Symptom fluctuation in eating disorders: correlates of diagnostic crossover.},
  author={Federica Tozzi and Laura M. Thornton and Kelly L. Klump and Manfred Maximilian Fichter and Katherine A Halmi and Allan S. Kaplan and Michael A. Strober and D Blake Woodside and Scott J Crow and James Mitchell and Alessandro Rotondo and Mauro Mauri and Giovanni Battista Cassano and Pamela K. Keel and Katherine H Plotnicov and Christine Pollice and Lisa Rachelle Riso Lilenfeld and Wade H. Berrettini and Cynthia M. Bulik and Walter H. Kaye},
  journal={The American journal of psychiatry},
  volume={162 4},
OBJECTIVE The course of anorexia nervosa often includes the emergence of bulimic symptoms and a crossover to the full syndrome of bulimia nervosa. However, clinicians' ability to predict who will develop bulimia nervosa is limited. The converse phenomenon, crossover from bulimia nervosa to anorexia nervosa, has not been investigated as thoroughly. The authors identified factors that are associated with crossover from anorexia nervosa to bulimia nervosa and from bulimia nervosa to anorexia… 

Figures and Tables from this paper

Diagnostic crossover in anorexia nervosa and bulimia nervosa: implications for DSM-V.
Findings support the longitudinal distinction of anorexia nervosa and bulimia nervosa but do not support the anoremia nervosa subtyping schema.
Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa
A tendency toward obesity among patients who cross over from AN-R to BN is suggested, and low self-directedness and high parental criticism may be associated with the development of BN by patients withAN-R.
Genetic and environmental contributions to diagnostic fluctuation in anorexia nervosa and bulimia nervosa
Abstract Background Anorexia nervosa and bulimia nervosa are two severe eating disorders associated with high premature mortality, suicidal risk and serious medical complications. Transition between
Outcome of eating disorders.
  • H. Steinhausen
  • Psychology, Medicine
    Child and adolescent psychiatric clinics of North America
  • 2009
Should bulimia nervosa be subtyped by history of anorexia nervosa? A longitudinal validation.
Lifetime AN is an important prognostic indicator among women with BN and these longitudinal data would support the subtyping of BN on the basis of AN history, and there were no between-group differences in likelihood of partial recovery.
Personality subtyping and bulimia nervosa: psychopathological and genetic correlates
Findings suggest that the bulimia nervosa diagnostic category is comprised of three classes of individuals based on co-morbid psychopathology and personality, which may have significant etiological and treatment implications.
The Physiology of Anorexia Nervosa and Bulimia Nervosa
It is estimated that only about 33 % of AN patients and 6 % of BN are receiving proper treatment for their illnesses, and Successful treatment of EDs should be managed with a team-based approach including the physician, psychologist, and registered dietitian.
Factors associated with recovery from anorexia nervosa.
Bulimia nervosa with history of anorexia nervosa: could the clinical subtype of anorexia have implications for clinical status and treatment response?
The influence of the anorexia nervosa subtype in BN/AN+ patients is worthy of further study as it might have clinical implications.


A study of temperament and personality in anorexia and bulimia nervosa.
Impulsivity seems to be a key aspect of temperament of bulimic patients, whereas anorexic symptoms are linked to persistent temperament traits, and Cluster C personality disorders seem more common in anorexia nervosa restricting type and impulsive personality features are associated with Bulimic symptoms.
Controlled family study of anorexia nervosa and bulimia nervosa: evidence of shared liability and transmission of partial syndromes.
Both anorexia nervosa and bulimia nervosa are familial, and the observation that familial aggregation and cross-transmission extend to milder phenotypes suggests the validity of their inclusion in a continuum of familial liability.
The natural course of bulimia nervosa and binge eating disorder in young women.
It is suggested that, among young women in the community, bulimia nervosa and binge eating disorder have a different course and outcome.
Personality dimensions in eating disorders and their relevance for subtyping.
The results suggest that a personality disposition toward overcontrol and reserve might constitute a risk factor for the restricting type of anorexia nervosa through fostering restrictive behavior toward food and avoidance of personal relationships.
A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity.
Relatives of anorexic and bulimic probands had increased risk of clinically subthreshold forms of an eating disorder, major depressive disorder, and obsessive-compulsive disorder and obsessional personality traits may be a specific familial risk factor for anorexia nervosa.
Outcome of anorexia nervosa: eating attitudes, personality, and parental bonding.
The domains of personality, character, and parental bonding differ among categories of recovery in anorexia nervosa, and whether these differences contribute to recovery or emerge during recovery or lack thereof remains an unanswered question.
Measurement of nonclinical personality characteristics of women with anorexia nervosa or bulimia nervosa.
In logistic regression analyses, women with anorexia nervosa evidenced greater degrees of control and general constraint, and a lower degree of absorption in sensory experiences relative to those with bulimia nervosa, highlighting the importance of considering nonclinical personality features and temperament in the understanding of predisposing factors for eating disorders.
A prospective study of outcome in bulimia nervosa and the long-term effects of three psychological treatments.
While the three treatments did not differ with respect to the proportion of subjects with anorexia nervosa or bulimia nervosa at follow-up, they did differ once all forms of DSM-IV eating disorder were considered together.
Longitudinal comparison of anorexia nervosa subtypes.
The high crossover rate in the sample from ANR to ANBP suggests that ANR represents a phase in the course of AN rather than a distinct subtype, and the findings on impulsivity, course, and outcome do not support the current subtyping system.
Outcome in bulimia nervosa.
Treatment interventions may speed eventual recovery but do not appear to alter outcome more than 5 years following presentation, and personality traits, such as impulsivity, may contribute to poorer outcome.