Obsessions and Compulsions Continue After Bulimia Remits

TORONTO – Comorbid obsessive and compulsive behaviors persist in women with bulimia nervosa, even after the abnormal eating patterns associated with the condition have been successfully treated, Dr. Jessica C. Morgan said at the annual meeting of the American Psychiatric Association.

This finding suggests that elevated obsessive and compulsive ratings may reflect a persistent trait characteristic in individuals who develop the eating disorder–a discovery that “could lead to new treatment strategies for managing anxiety symptoms in at-risk individuals, particularly those in the recovery stages of bulimia,” said Dr. Morgan of the department of psychiatry at Dartmouth Medical School in Hanover, N.H.

Because previous studies have linked obsessive and compulsive behaviors to the primary symptoms of bulimia, Dr. Morgan and her colleagues sought to determine whether remission from bulimia had an impact on co-occurring obsessive-compulsive symptoms.

Using subject self-ratings on the Maudsley Obsessive-Compulsive Inventory (MOCI), the investigators compared the obsessive-compulsive characteristics of 25 women with active bulimia, 21 of whom were in recovery from bulimia, and 28 healthy controls–all of whom were medication free at the time of the assessment. The investigators also looked at participants' mean scores on the Eating Attitudes Test (EAT), which assesses disordered eating attitudes, and the Spielberger Trait Anxiety Inventory (STAI), which tests for anxiety disorders.

“As we had expected, the MOCI scores for the bulimia group were significantly elevated, compared to those of the controls,” said Dr. Morgan, noting that the respective scores were 5.4 vs. 2.5 on the 30-item true-false questionnaire designed to assess overt rituals and their related obsessions. “The recovery group had similarly elevated MOCI scores [5.5],” she said, which suggests that those aspects of the disease associated with obsessive-compulsive behaviors were not affected by treatment.

In contrast, the EAT and STAI scores for the women in recovery were significantly reduced, compared with those of the women with active bulimia, “although they were still significantly higher than what we observed in the control group,” Dr. Morgan said.

The persistence of obsessive-compulsive symptoms after recovery from bulimia not only suggests that such behaviors may be trait related in affected individuals, but also raises the possibility that the behaviors contribute somehow to the pathogenesis of the eating disorder, she noted.

Although more research is needed to clarify the relationship between the cooccurring conditions, the demonstrated link between the two may help clinicians more readily identify bulimia patients at risk for lingering obsessive-compulsive symptoms, Dr. Morgan said.

TORONTO – Comorbid obsessive and compulsive behaviors persist in women with bulimia nervosa, even after the abnormal eating patterns associated with the condition have been successfully treated, Dr. Jessica C. Morgan said at the annual meeting of the American Psychiatric Association.

This finding suggests that elevated obsessive and compulsive ratings may reflect a persistent trait characteristic in individuals who develop the eating disorder–a discovery that “could lead to new treatment strategies for managing anxiety symptoms in at-risk individuals, particularly those in the recovery stages of bulimia,” said Dr. Morgan of the department of psychiatry at Dartmouth Medical School in Hanover, N.H.

Because previous studies have linked obsessive and compulsive behaviors to the primary symptoms of bulimia, Dr. Morgan and her colleagues sought to determine whether remission from bulimia had an impact on co-occurring obsessive-compulsive symptoms.

Using subject self-ratings on the Maudsley Obsessive-Compulsive Inventory (MOCI), the investigators compared the obsessive-compulsive characteristics of 25 women with active bulimia, 21 of whom were in recovery from bulimia, and 28 healthy controls–all of whom were medication free at the time of the assessment. The investigators also looked at participants' mean scores on the Eating Attitudes Test (EAT), which assesses disordered eating attitudes, and the Spielberger Trait Anxiety Inventory (STAI), which tests for anxiety disorders.

“As we had expected, the MOCI scores for the bulimia group were significantly elevated, compared to those of the controls,” said Dr. Morgan, noting that the respective scores were 5.4 vs. 2.5 on the 30-item true-false questionnaire designed to assess overt rituals and their related obsessions. “The recovery group had similarly elevated MOCI scores [5.5],” she said, which suggests that those aspects of the disease associated with obsessive-compulsive behaviors were not affected by treatment.

In contrast, the EAT and STAI scores for the women in recovery were significantly reduced, compared with those of the women with active bulimia, “although they were still significantly higher than what we observed in the control group,” Dr. Morgan said.

The persistence of obsessive-compulsive symptoms after recovery from bulimia not only suggests that such behaviors may be trait related in affected individuals, but also raises the possibility that the behaviors contribute somehow to the pathogenesis of the eating disorder, she noted.

Although more research is needed to clarify the relationship between the cooccurring conditions, the demonstrated link between the two may help clinicians more readily identify bulimia patients at risk for lingering obsessive-compulsive symptoms, Dr. Morgan said.

TORONTO – Comorbid obsessive and compulsive behaviors persist in women with bulimia nervosa, even after the abnormal eating patterns associated with the condition have been successfully treated, Dr. Jessica C. Morgan said at the annual meeting of the American Psychiatric Association.

This finding suggests that elevated obsessive and compulsive ratings may reflect a persistent trait characteristic in individuals who develop the eating disorder–a discovery that “could lead to new treatment strategies for managing anxiety symptoms in at-risk individuals, particularly those in the recovery stages of bulimia,” said Dr. Morgan of the department of psychiatry at Dartmouth Medical School in Hanover, N.H.

Because previous studies have linked obsessive and compulsive behaviors to the primary symptoms of bulimia, Dr. Morgan and her colleagues sought to determine whether remission from bulimia had an impact on co-occurring obsessive-compulsive symptoms.

Using subject self-ratings on the Maudsley Obsessive-Compulsive Inventory (MOCI), the investigators compared the obsessive-compulsive characteristics of 25 women with active bulimia, 21 of whom were in recovery from bulimia, and 28 healthy controls–all of whom were medication free at the time of the assessment. The investigators also looked at participants' mean scores on the Eating Attitudes Test (EAT), which assesses disordered eating attitudes, and the Spielberger Trait Anxiety Inventory (STAI), which tests for anxiety disorders.

“As we had expected, the MOCI scores for the bulimia group were significantly elevated, compared to those of the controls,” said Dr. Morgan, noting that the respective scores were 5.4 vs. 2.5 on the 30-item true-false questionnaire designed to assess overt rituals and their related obsessions. “The recovery group had similarly elevated MOCI scores [5.5],” she said, which suggests that those aspects of the disease associated with obsessive-compulsive behaviors were not affected by treatment.

In contrast, the EAT and STAI scores for the women in recovery were significantly reduced, compared with those of the women with active bulimia, “although they were still significantly higher than what we observed in the control group,” Dr. Morgan said.

The persistence of obsessive-compulsive symptoms after recovery from bulimia not only suggests that such behaviors may be trait related in affected individuals, but also raises the possibility that the behaviors contribute somehow to the pathogenesis of the eating disorder, she noted.

Although more research is needed to clarify the relationship between the cooccurring conditions, the demonstrated link between the two may help clinicians more readily identify bulimia patients at risk for lingering obsessive-compulsive symptoms, Dr. Morgan said.