Dynamics of bulimia disorders in anorexia nervosa and bulimia nervosa

Thirty-three female patients with anorexia nervosa (AN) with bulimia disorders and 54 with bulimia nervosa (BN) were studied. The analysis of clinical presentations and dynamics of bulimia disorders in these groups revealed the similarity of types of "purging" behavior. At the same time, NA differs by the absence of genuine binge attacks characteristic of the patients with BN. Psychopathological basis of the "purging" behavior in AN seems to be dysmorphophobic, anxiety, hypochondriac disorders as well as insufficient criticism of a patient's state in the absence of pronounced affective disorders and reduced self-esteem and that in BN - cyclothymic, bipolar affective disorders and disorders of drive, dysmorphophobic concerns related to the changes of self-esteem. Also, patients with BN have criticism towards their behavior. These differences should be taken into account in the choice of therapeutic tactics and methods as well as in rehabilitation of patients with eating disorders.