Associations between self-induced vomiting and personality disorder in patients with a history of anorexia nervosa

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Abstract
Fifty-five patients of an eating disorders service with a history of anorexia nervosa (AN), defined by a history of refusal to maintain body weight above a level of 15% below that expected, completed a modified version of the revised Personality Diagnostic Questionnaire (PDQ-R) based on DSM-III-R personality disorders (PD). The subjects were divided into 2 groups based on AN subtypes: vomiters, defined by a history of self-induced vomiting, and non-vomiters, who had maintained low weight mainly or only by diet +/- excessive exercise. Vomiters showed significantly higher scores on self-report measures of borderline and antisocial PD criteria. Discriminant analysis based on PD scores for all 13 DSM-III-R PD categories correctly predicted AN subtype membership based on vomiting history in 85.5% of patients. The implications of PD comorbidity for the development and management of eating disorders are discussed.