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The British Journal of Psychiatry (2000) 177: 72-76
© 2000 The Royal College of Psychiatrists

Reliability of lifetime history of bulimia nervosa

Comparison with major depression

TRACEY D. WADE, PhD, CYNTHIA M. BULIK, PhD and KENNETH S. KENDLER, MD

Virginia Institute for Psychiatric and Behavioral Genetics, Department ofPsychiatry, Medical College of Virginia, Virginia Commonwealth University,Richmond, Virginia, USA

Correspondence: Associate Professor Cynthia M. Bulik, Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, PO Box 980126, Richmond, VA 23298-0126, USA. Tel : 001 804 828 8133 ; Fax : 001 804 828 1471

Declaration of interest None.

Background Previous studies have found that the reliability of the lifetime prevalence of bulimia nervosa is low to moderate. However, the reasons for poor reliability remain unknown.

Aims We investigated the ability of a range of variables to predict reliability, sensitivity, and specificity of reporting of both bulimia nervosa and major depression.

Method Two interviews, approximately 5 years apart, were completed with 2163 women from the Virginia Twin Registry.

Results After accounting for different base rates, bulimia nervosa was shown to be as reliably reported as major depression. Consistent with previous studies of major depression, improved reliability of bulimia nervosa reporting is associated with more severe bulimic symptomatology.

Conclusions Frequent binge eating and the presence of salient behavioural markers such as vomiting and laxative misuse are associated with more reliable reporting of bulimia nervosa. In the absence of the use of fuller forms of assessment, brief interviews should utilise more than one prompt question, thus increasing the probability that memory of past disorders will be more successfully activated and accessed.




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