The correlates of diagnostic instability in eating disorders: the role of psychopathology, environmental risk factors, personality and genes

Abstract

Aim To assess the occurrence of diagnostic cross-over in Eating Disorders (EDs) and assess its relationship with psycho-pathology, environmental risk factors, personality and genes. Method Participants were 316 ED patients. The EATATE part 1 (a semi-structured interview) was used to examine diagnostic cross-over in EDs. The Eating Disorder Inventory (EDI-2), Temperament and Character Inventory (TCI-R), Oxford Risk Factor Interview (ORFI), the EATATE part 2 [used to assess obsessive-compulsive personality (OCPD) traits and impulsive behaviours] and four candidate genes (5-HT2A, BDNF, 5-HTTLPR, DRD4) were used to assess differences in cross-over patterns. Results The majority of ED patients (65%) presented with diagnostic instability. The most commom cross-over change (23.42%) was from Anorexia Nervosa Restrictive (AN-R) subtype to a bulimic disorder. Significant differences across four ED cross-over groups [1.) AN-R to bulimic disorder; 2.) bulimic disorder to AN-R (5.6%); 3.) threshold ED to EDNOS (10.76%); 4.) EDNOS to threshold ED (6.7%)], a stable group (34.5%) and a remitted group (18.67%) were obtained the EDI bulimia, asceticism and impulse regulation subscales, the TCI-R self-directide-ness and cooperativeness subscales, childhood OCPD traits and impulsive behaviours (p