Are there subgroups of bulimia nervosa based on comorbid psychiatric disorders?

Alexis E. Duncan, Rosalind J. Neuman, John Kramer, Samuel Kuperman, Victor Hesselbrock, Theodore Reich, Kathleen K. Bucholz

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Objective: The current study sought to determine whether there are subtypes of bulimia nervosa (BN) differentiated by comorbid psychiatric disorders. Method: Data on comorbid psychiatric diagnoses in female relatives of probands and controls in the Collaborative Study of the Genetics of Alcoholism (COGA) who met criteria for BN (as outlined in the 3rd Rev. ed. of the Diagnostic and Statistical Manual of Mental Disorders) were analyzed using latent class analysis. Resulting latent classes were compared on a variety of variables related to impulsive behaviors and psychological functioning. Results: The best-fitting solution, a two-class model, yielded one class (72%) characterized by substance dependence, depression, antisocial personality disorder (ASPD), and anxiety disorders, and another characterized by depression. The highly comorbid class had more suicidality, more daily smokers, sought help for emotional problems, and had lower Global Assessment of Functioning (GAF) scores compared with those in the comorbid depression only class. Discussion: Latent class findings suggest the existence of two classes of BN differentiated by substance dependence, impulsive behaviors, and poorer psychological functioning.

Original languageEnglish
Pages (from-to)19-25
Number of pages7
JournalInternational Journal of Eating Disorders
Issue number1
StatePublished - Jan 2005


  • Bulimia nervosa
  • COGA
  • Poor psychological functioning
  • Substance dependence


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