Eating disorder not otherwise specified (EDNOS) is only a “residual diagnosis” in the Diagnostic and Statistical Manual of Mental Disorders. However, there is an increasing number of EDNOS diagnosed people in the out patient setting. This research deals with the EDNOS-P or purging disorder, which is included in the DSM-IV, in comparison with Bulimia Nervosa Purging type (BN-P). EDNOS-P is twice more prevalent than BN-P but is a condition most ignored by research.
In this study, the experimental group showed increased state anxiety, impulsiveness, impulse control disorder and life time mood, substance abuse, anxiety disorder, and Axis II disorder. There are three groups of women with a mean age of 35 years old (aged 28 to 40 years) from a cohort of 4,268 pairs of twins included in this study. One group is composed of the healthy controls and the other two groups is composed of EDNOS-P and BN-P experimentals.
The data were taken via telephone interview using the Eating Order Examination (EOE) which examines the eating pathology and disorders and via self report questionnaires. For the self report questionnaires, temperament measures related to eating disorders were examined. These were: self esteem, type of perfectionism, impulsivity, and depressive psychopathology measuring suicidality. There was a random selection of 22 taped interviews (9 featuring lifetime BN, 5 with BED and 8 featuring EDNOS-P).
Data analysis were gathered by using the logistic regression to compare BN-P and EDNOS-P with respect to different characteristics of the different purging behaviors and by using the linear mixed effects modeling to measure the three groups to be compared with respect to current eating, BMI, lifetime depressive psychopathology and personality. Results revealed 22 women who met full DSM-IV criteria for BN-P and 53 women who met full DSM-IV criteria for EDNOS-P with threshold purging.
Those who were classified as to have had no lifetime behavior of eating disorder had no BMI of less than or equal to 17. 5, self induced vomiting, objective binging episodes, diuretic use, laxative use, and fasting within at least 8 waking hours for weight or body shape control. Comparisons between BN-P versus EDNOS-P showed that BN-P patients have an increased tendency to induce vomiting, increased eating concern and dietary restraint, and a lower tendency to use laxatives. With a higher vomiting tendency for those with BN-P, this indicates a lower self directedness, organization and personal standards.
This also indicates a higher novelty seeking behavior. The control group had no significant difference with the experimental groups with regards to BMI and impulsivity. But the experimental group showed higher concern for weight and body shape, dietary restraint, lifetime major depression, and suicidality. This retrospective study shows that EDNOS-P patients are in between being healthy and having the condition of BN-P. Lifetime EDNOS patients have higher laxative use and need further research for the nature of their condition.
Moreover, further studies of EDNOS will provide medical practitioners and people suffering from this disorder more meaning and insight about the enduring differences of this case to deem this condition clear and to administer prompt, accurate treatment. Reference Wade, T. (2007) A Retrospective Comparison of Purging Type Disorders: Eating Disorder Not Otherwise Specified and Bulimia Nervosa. International Journal of Eating Disorders, 40 1-6. Retrieved April 21, 2009, from the World Wide Web: http://www. ssn. flinders. edu. au/psyc/staff/TraceyWade/A%20Retrospective%20Comparison%20of%20Purging%20Type. pdf