The significance of a history of childhood sexual abuse in bulimia nervosa.
P F Sullivan, C M Bulik, F A Carter, P R Joyce


BACKGROUND Childhood sexual abuse (CSA) is found to have occurred to a substantial minority of women with bulimia nervosa. Its clinical significance is unclear.

METHOD We studied 87 bulimic women in a clinical trial. Structured interviews determined the presence of CSA, DSM-III-R disorders, global functioning, and depressive and bulimic symptoms.

RESULTS Forty-four per cent reported a history of CSA. Bulimic women with CSA reported earlier onset of bulimia, greater depressive symptoms, worse global functioning and more suicide attempts, and were more likely to meet criteria for bipolar II disorder, alcohol and drug dependence, conduct disorder and avoidant personality disorder.

CONCLUSIONS Although those with CSA had greater comorbidity, it was not an important modifier of bulimic symptoms.