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Neuropsychological function in bulimia with comorbid borderline personality disorder and depression

Published online by Cambridge University Press:  24 June 2014

Cecilia M. Bourke
Affiliation:
Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand
Richard J. Porter*
Affiliation:
Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand
Patrick Sullivan
Affiliation:
UNC Departments of Genetics, Psychiatry, and Epidemiology, Carolina Center for Genome Sciences, Chapel Hill, North Carolina, USA
Cynthia M. Bulik
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina, USA
Frances A. Carter
Affiliation:
Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand
Virginia V. McIntosh
Affiliation:
Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand
Peter R. Joyce
Affiliation:
Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand
*
Richard J. Porter, MB BS, MD, MA, DipObst, MRCPsych, Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch 8140, New Zealand. Tel: +64-3-372-0400; Fax: +64-3-372-0407; E-mail: [email protected]

Abstract

Background:

In bulimia nervosa (BN), borderline personality disorder (BPD) and major depression (MDD) are frequently comorbid conditions. Executive function has been found to be impaired in BPD and MDD, but the impact of comorbidity on neuropsychological function has rarely been investigated.

Objective:

To investigate neuropsychological function in BN with a focus on comorbid BPD and MDD.

Methods:

One hundred forty-four medication-free female patients entering a study of psychological treatments for BN performed a brief battery of neuropsychological tests. Comorbid MDD and BPD were systematically identified using standard interviews. Neuropsychological test results were compared.

Results:

Forty-one subjects had comorbid BPD and 35 had comorbid MDD, while 15 had both. There was no effect of comorbid MDD, but there was a significant effect of BPD and a significant interaction between the diagnosis of MDD and BPD on executive tasks (trail making and Stroop). Thus, compared with subjects without BPD, subjects with BPD performed significantly worse on tests of executive function, while the group with both comorbidities performed even worse.

Conclusions:

There appears to be an additive effect of BPD and MDD resulting in impaired executive neuropsychological function. Future studies on either disorder and on BN should examine and account for the effect of comorbidity.

Type
Research Article
Copyright
Copyright © 2006 Blackwell Munksgaard

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