n South African Psychiatry Review - Bulimia nervosa in adolescents : treatment, eating pathology and comorbidity : research article




Background : Bulimia nervosa (BN) is occurring with increasing frequency among adolescents. Yet, few studies have undertaken to detail the clinical presentation, or investigate different treatments for adolescents with BN. <br>Objective : In this article, we 1) review our current knowledge of BN in adolescents, both in terms of clinical presentation and treatment possibilities, and 2) describe a cohort of adolescent bulimics in terms of eating pathology and comorbidity. <br>Subjects : Twenty-seven consecutive referrals for adolescent BN to The University of Chicago Hospitals are presented here (mean age=16.2 yrs, sd+1.4). These patients are among the first to be evaluated for participation in an ongoing randomized controlled trial of two psychosocial treatments. <br>Measures : Eating pathology was measured with the Eating Disorders Examination (EDE), while the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) was used to establish comorbid psychiatric diagnoses. <br>Results : Our findings indicate that this cohort is quite diverse in terms of ethnicity and family environment. Rates of comorbid depression are much higher in our cohort than in a comparable sample of adult BN. In most other respects, the clinical presentation of BN in our sample of adolescents appears to be similar to that in adults. <br.Conclusion : Comorbidity and adolescent developmental status are two obvious factors that should be taken into account in the evaluation of effective treatments for adolescent BN.


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