Purging behaviors, suicide attempts, and psychiatric symptoms in 398 eating disordered subjects.

OBJECTIVE: The present work investigates differences in psychiatric symptoms and self-injurious behaviors among different forms of purging behavior in eating disorders (ED).

METHOD: The sample was composed of 398 subjects consecutively referred to an outpatient ED unit.

RESULTS: Both in anorexia nervosa (AN) and bulimia nervosa (BN), psychiatric symptoms were significantly more serious in purging compared to nonpurging groups, while no significant difference emerged among divergent forms of purging behaviors. The presence of multiple methods to control weight appeared to be a predictor of impulsive behaviors, as subjects who used both vomiting and laxatives reported significantly higher frequency of self-injurious behaviors. In BN, the self-injury was often a suicide attempt.

DISCUSSION: The impact of purging behavior on the prognosis of AN and BN should be further studied since our research has shown a trend towards more frequent self-damaging behaviors in subjects who resort to multiple forms of purging behavior.