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International symposium on eating disorders
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EDITORIAL INTERNATIONAL
SYMPOSIUM
ON EATING
DISORDERS
THIS supplement is based on an international symposium on bulimia held at the 8th World Psychiatric Association Conference in Athens in October 1989. The symposium brought together four of the world’s most prominent experts on bulimia nervosa and each presented a critical review of one area of this fascinating disorder. Since the symposium the talks have been expanded and brought further up to date so that recent developments could be included. The meeting was a timely one, 1989 being the 10th anniversary of the first extensive clinical descriptions of bulimia nervosa [l]. It is striking that although bulimia nervosa has been more recently described than its sister condition anorexia, it has attracted a much greater volume and a much higher quality of research than anorexia nervosa. There are now over 50 studies into its clinical boundaries, incidence and prevalence and over 25 controlled treatment trials. The five papers in this supplement cover many of the important areas where this research has been carried out. Doctor Chris Fairbairn covers the epidemiology and clinical features of the disorder which have been much debated over the past 10 years. Although the DSM-III(R) criteria are now the most widely used there is still no general agreement about where the boundaries of the disorder should be drawn and how it relates to anorexia nervosa and obesity. Doctor Paul Garfinkel covers the biochemistry and endocrinology of the disorder and gives us an understanding of how the numerous physical side effects of bulimia nervosa develop and also why certain pharmacological interventions may be effective. Doctor Jim Mitchell reviews, in a critical way, all the published studies on the psychotherapy of bulimia nervosa and includes some very recent information on his own extensive trails comparing drug treatment with psychotherapy. Doctor Tim Walsh reviews the drug treatment for this disorder and presents some pre-publication data on the large North American study of Fluoxetine versus placebo. Finally, I have attempted to draw some strands together and provide a simple, practical set of treatment guidelines for clinicians who may be treating this disorder and who are not working in specialised eating disorder clinics. REFERENCE I.
RUSSELL GFM.
Bulimia
Nervosa:
An ominous
variant
ol’ anorexia
ner’vosa.
P.c~~ho/ Mrd
IY7Y;
9:42Y441.
Edinburgh
1
University
DR C. P. FREEMAN Department of Psychiatry Royal Edinburgh Hospital Morningside Park Edinburgh EHlO SHF U.K.
EDITORIAL INTERNATIONAL
SYMPOSIUM
ON EATING
DISORDERS
THIS supplement is based on an international symposium on bulimia held at the 8th World Psychiatric Association Conference in Athens in October 1989. The symposium brought together four of the world’s most prominent experts on bulimia nervosa and each presented a critical review of one area of this fascinating disorder. Since the symposium the talks have been expanded and brought further up to date so that recent developments could be included. The meeting was a timely one, 1989 being the 10th anniversary of the first extensive clinical descriptions of bulimia nervosa [l]. It is striking that although bulimia nervosa has been more recently described than its sister condition anorexia, it has attracted a much greater volume and a much higher quality of research than anorexia nervosa. There are now over 50 studies into its clinical boundaries, incidence and prevalence and over 25 controlled treatment trials. The five papers in this supplement cover many of the important areas where this research has been carried out. Doctor Chris Fairbairn covers the epidemiology and clinical features of the disorder which have been much debated over the past 10 years. Although the DSM-III(R) criteria are now the most widely used there is still no general agreement about where the boundaries of the disorder should be drawn and how it relates to anorexia nervosa and obesity. Doctor Paul Garfinkel covers the biochemistry and endocrinology of the disorder and gives us an understanding of how the numerous physical side effects of bulimia nervosa develop and also why certain pharmacological interventions may be effective. Doctor Jim Mitchell reviews, in a critical way, all the published studies on the psychotherapy of bulimia nervosa and includes some very recent information on his own extensive trails comparing drug treatment with psychotherapy. Doctor Tim Walsh reviews the drug treatment for this disorder and presents some pre-publication data on the large North American study of Fluoxetine versus placebo. Finally, I have attempted to draw some strands together and provide a simple, practical set of treatment guidelines for clinicians who may be treating this disorder and who are not working in specialised eating disorder clinics. REFERENCE I.
RUSSELL GFM.
Bulimia
Nervosa:
An ominous
variant
ol’ anorexia
ner’vosa.
P.c~~ho/ Mrd
IY7Y;
9:42Y441.
Edinburgh
1
University
DR C. P. FREEMAN Department of Psychiatry Royal Edinburgh Hospital Morningside Park Edinburgh EHlO SHF U.K.