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Impact of pregnancy on bulimia nervosa

Published online by Cambridge University Press:  02 January 2018

John Farnill Morgan ,
J. Hubert Lacey  and
Philip M. Sedgwick
John Farnill Morgan*
Affiliation:
Department of General Psychiatry, St George's Hospital Medical School, London
J. Hubert Lacey
Affiliation:
Department of General Psychiatry, St George's Hospital Medical School, London
Philip M. Sedgwick
Affiliation:
Department of General Psychiatry, St George's Hospital Medical School, London
*
Dr Morgan, Department of General Psychiatry, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE; e-mail: jmorgan@sghms.ac.uk
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Abstract

Background

Bulimia nervosa affects women at a peak age of reproductive functioning, but few studies have examined the impact of pregnancy on bulimia.

Aim

To examine the impact of pregnancy on symptoms of bulimia nervosa and associated psychopathology.

Method

Women actively suffering from bulimia nervosa during pregnancy (n=94) were interviewed using the eating disorder examination (12th edn) and structured clinical interview for DSM–III–R, with additional structured questions. Behaviours were recorded at conception, each trimester and postnatally. Relative risks were calculated for prognostic factors.

Results

Bulimic symptoms improved throughout pregnancy. After delivery, 57% had worse symptoms than pre-pregnancy, but 34% were no longer bulimic. Relapse was predicted by behavioural severity and persistence, previous anorexia nervosa (‘Type II’ bulimia), gestational diabetes and ‘unplanned’ pregnancy. Unplanned pregnancies were the norm, usually resulting from mistaken beliefs about fertility. ‘Postnatal depression’ was suggested in one-third of the sample, and in two-thirds of those with ‘Type II’ bulimia, and was predicted by alcohol misuse, symptom severity and persistence.

Conclusions

Postnatal treatment intervention should focus on women ‘at risk’ of relapse, but all women with bulimia should be assessed for postnatal depression.

Type
Papers
Information
The British Journal of Psychiatry , Volume 174 , Issue 2 , February 1999 , pp. 135 - 140
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest None.

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