Inducing Factors for Chronicity of Eating Disorders from Psychological, Physiological, and Behavioral Points of View

Abstract

Objectives : Inducing factors for chronicity of eating disorders (ED) were examined in two aspects : parental rearing experiences (Study 1) and the effect of long-term starvation (Study 2). Subjects and Method : The ED group for Study I consisted of 67 ED patients who were inpatients or outpatients of Kagoshima Univ. hospital, Kyushu Univ. hospital, and Takei Medical Clinic, during the period from April to September 2003. They each completed a questionnaire. As a control group, 82 healthy participants participated in the study and completed the same questionnaire. The parental rearing experiences at the age of 15 were retrospectively examined by the Egna Minnen av Barndoms Uppfostran (EMBU) scoring system, and compared between the two groups. In Study 2, 131 ED patients in Kagoshima Univ. hospital during the period from January to December 2002 were involved. In order to clarify the relation between the chronicity of ED and the starvation condition, clinical features such as subtypes, age of onset, age at the time of the investigation, period of illness, and past history were investigated in the ED patients. Results : Study I : The mean EMBU score "rejection" was significantly higher in parents of the ED group than that of the control group (p <0.01). In addition the score "emotional warmth" was also significantly lower in the ED group than the other (p <0.01) . The score "over protection" (m both "study" and "interference") of fathers was lower m the ED group than the other significantly (p <0.05) . The score "favoring subject" of mothers was also significantly higher in the ED group (p <0.05.) . Study 2 : Of 131 outpatients, 31 cases had chronic courses that lasted for more than 10 years ; they were AN-R cases in 7, AN-BP in 12, BN-P in 6. BN-NP in one, and EDNOS in 5. Average BMI (body mass index) in each patient group was 12.7 in AN-R, 13.4 in AN-BP, 17.8 in BN-P, 18.3 in BN-NP, and 17.3 in EDNOS. More than 80% of the patients were either AN-R, AN-BP, or BN-P. They were suspected to have been under semi-starvation condition for a long time due to food restriction or purging behavior followed by over eating. Conclusion : The problems in parental rearing experiences, and physiological starvation for long periods of time were estimated to be the significant inducing factors for chronicity of ED.