Abstract
Recently, the association of personality disorders and eating disorders has received much attention since the establishment of the DSM-III criteria for personality disorders on Axis II. Several studies have examined the comorbidity of eating disorders and DSM-III-R personality disorders and demonstrated that 50〜70% of eating disordered individuals meet the criteria for at least one personality disorder. In this study, the prevalence of personality disorders was assessed in 22 patients with restricting anorexia nervosa (AN) , 20 patients with anorexia nervosa and bulimia nervosa (AN+BN) and 21 patients with bulimia nervosa (BN) using the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID- II) . Fifty-four percent of all subjects met criteria for at least one personality disorder. Patients with personality disorders, especially borderline personality disorder had more severe clinical features in terms of bulimic behaviors, suicidal attempts, concurrent depressive, anxious and obsessive-compulsive symptoms, psychopathology related to eating disorders and social global functioning than patients without any personality disorders. Patients with personality disorders tended to be more often hospitalized. These results suggest that comorbidity of personality disorders in patients with eating disorders has a strong influence on a variety of clinical features and appears to be related to poor prognosis. With respect to the treatment of the eating-disordered patients with personality disorders, it is important to assess the individual for overall level of functioning, treatment readiness and environmental factors when determining treatment strategies. The importance of establishing a therapeutic alliance, preparing for destructive and counterproductive behaviors, use of psychotropic medications and supporting family members should be emphasized in the treatment of these patients.
