Do adolescents with eating disorder not otherwise specified or full-syndrome bulimia nervosa differ in clinical severity, comorbidity, risk factors, treatment outcome or cost?

Int J Eat Disord. 2008 Sep;41(6):498-504. doi: 10.1002/eat.20533.

Abstract

Objective: We wanted to know whether adolescents with eating disorder not otherwise specified (EDNOS) differ from those with bulimia nervosa (BN) in clinical features, comorbidity, risk factors, treatment outcome or cost.

Method: Adolescents with EDNOS (n = 24) or BN (n = 61) took part in a trial of family therapy versus guided self-care. At baseline, eating disorder symptoms, risk factors, and costs were assessed by interview. Patients were reinterviewed at 6 and 12 months.

Results: Compared with EDNOS, BN patients binged, vomited and purged significantly more, and were more preoccupied with food. Those with EDNOS had more depression and had more current and childhood obsessive-compulsive disorder. 66.6% of EDNOS versus 27.8% of BN patients were abstinent from bingeing and vomiting at 1 year. Diagnosis did not moderate treatment outcome. Costs did not differ between groups.

Conclusion: EDNOS in adolescents is not trivial. It has milder eating disorder symptoms but more comorbidity than BN.

MeSH terms

  • Adolescent
  • Adult
  • Bulimia Nervosa* / economics
  • Bulimia Nervosa* / epidemiology
  • Bulimia Nervosa* / therapy
  • Comorbidity
  • Costs and Cost Analysis
  • Family Therapy / methods*
  • Female
  • Humans
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Self Care
  • Self Efficacy
  • Surveys and Questionnaires
  • Treatment Outcome