Comparison of Clinical Symptoms of Anorexia Nervosa and Bulimia

Abstract

1. Eating disorder is increasing in number remarkably. Thirteen years ago, the rate of the cases of eating disorder among all the newly visited patients of the year was only 0.2%, but last year, the rate increased up to 2.2%. Moreover, in addition to the increase of classical anorexia nervosa, the increase of bulimia was prominent. 2. In 1984 author experienced 51 cases of eating disorder. 20 cases were diagnosed as anorexia nervosa and 27 cases were bulimia. Four cases were atypical eating disorder. All cases were female except for one case of bulimia. Symptoms of anorexia nervosa and bulimia were compared and the results were as follows. The common symptoms of eating disorder were that the original weight in many cases was normal or rather less than the standard weight and cases of obesity were very rare. Mean age of onset was 18 years, and symptoms of bulimia started slightly later. In almost all the cases, such symptoms as fear of fatness, disturbance of body image were seen. Social adaptation was frequently disturbed. Dependence and/or aggression to mother was also frequent. Enlargement of salivary glands was specific. Some patients refused to take medication. In anorexia nervosa, only few cases had a previous record of psychiatric problems. Behavioral abnormalities during anorexia were also rare. So anorexia nervosa could be said as monosymptomatic. The patients were hyperactive. Amenorrhea was seen in all cases. Only few cases had sexual experiences. Diminution or loss of deep tendon reflexes were frequently observed. In bulimia, many cases had previous psychiatric problems and impulsive behavioral abnormalities during the episode of bulimia were also frequent. Marked irritability, symptoms of depression and ideas of self-blame were observed in almost all the cases. The patients were withdrawn and hypoactive. Amenorrhea was not always observed. Not so few cases had sexual experience. Deep tendon reflexes were diminished in bout half of the cases.