Sexual abuse in patients with eating disorder, patients with depression, and normal controls. A comparative study.

BACKGROUND: A history of sexual abuse has been widely reported in patients with eating disorders. However, the association does not appear to be specific, because a high rate of such abuse has also been found in other psychiatric patients.

METHOD: A standardised interview method was used to elicit details of sexual abuse in a psychiatrically normal control group and samples of patients with anorexia nervosa, bulimia nervosa, or depression.

RESULTS: An equally high rate of abuse was found in all three clinical samples. Among the patients with anorexia nervosa the presence of bulimic episodes was not found to be associated with reports of abuse; and among the patients with bulimia nervosa there was no relationship between abuse and a history of anorexia nervosa. Among the patients with eating disorders, borderline personality disorder, assessed by means of self-report questionnaire, was not found to be related to reports of abuse, although there was an association between abuse and both indices of impulsive behaviour and the overall level of personality disturbance.

CONCLUSIONS: Childhood sexual abuse appears to be a vulnerability factor for psychiatric disorder in general and not eating disorders in particular. The way in which abuse interacts with other aetiological factors to produce different psychopathological trajectories remains to be elucidated.