Subtyping eating disordered patients along drive for thinness and depression

Abstract

Altres ajuts: Partial financial support was received from the European Union (Framework-V Multicenter Research Grant, QCK1-1999-916; Seventh Framework Programme-FP7-ICT-215839-2007).CIBEROBN and CIBERSAM are an initiatives of ISCIII (Spain).

Subtyping individuals who binge eat by ''diet-DT'' and ''depression'' has yielded two valid and clinically useful subtypes that predict eating severity, comorbid psychopathology and outcome. The present study aimed to find four subtypes based on these dimensions and test their validity. Besides, it explored the distribution of eating disorder (ED) diagnoses across subtypes given their known heterogeneity, crossover and binge-eating fluctuation. Cluster analysis grouped 1005 consecutively admitted ED adult women into four subtypes, those previously described ''DT'' (22%), ''DT-depressive'' (29%), and ''mild DT'' (25%) and ''depressive-moderate DT'' (24%). Overall ''mild DT'' presented lower and ''DT-depressive'' greater eating and comorbid psychopathology than the rest, whereas ''pure DT'' and ''depressive-moderate DT'' presented no differences on bulimic symptoms but in psychopathology (p < .01). Finally, while BN-P patients were mostly and similarly distributed in the ''DT'' and ''DT-depressive'' subtypes than in the other, AN were in the new ''mild DT'' and ''depressive-moderate DT'' (p < .01). However, BN-NP, BED and EDNOS were similarly represented across subtypes. Results are discussed with regard to 1) the newly emerged subtypes that may explain cases in which DT prevents or does not predict binge eating; 2) the confluence of DT-depression that signaled greater eating and comorbid pathology, particularly self-control problems; 3) ED-DSM-diagnostic criteria.