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April 1982

Anorexia Nervosa and Bulimia-Reply.

Author Affiliations

Research Department Illinois State Psychiatric Institute 1601 W Taylor St Chicago, IL 60612 Katherine A. Halmi, MD Department of Psychiatry New York Hospital 21 Bloomingdale Rd White Plains, NY 10605
Department of Psychiatry Medical College of Virginia Box 710, MCV Station Richmond, VA 23298
Department of Psychiatry University of Minnesota Box 393 Mayo Building Minneapolis, MN 55455
Research Department Illinois State Psychiatric Institute 1601 W Taylor St Chicago, IL 60612

Arch Gen Psychiatry. 1982;39(4):488-489. doi:10.1001/archpsyc.1982.04290040082016

In Reply.  — We would like to comment on Drs Katz and Sitnick's proposal to solve the challenging and so far unresolved question of a psychiatric classification for AN by defining fasting or abstemious patients as compulsive personalities and patients with bulimia as borderline personalities, with "histrionic patients probably falling somewhere in the middle."It is indeed amazing that despite wide agreement to consider AN a predominantly psychological condition, no consensus exists about the identity of the central psychopathology in, and its relationship to, AN. In part this can be explained by the scarcity of carefully conducted psychological studies in AN, as opposed to the ample and excellent literature bearing on the biological processes of AN.Since, in psychiatric illness, we cannot subgroup according to a common etiology or pathophysiologic factor, we usually attempt to subgroup according to the (1) history of the current illness, (2) initial pattern of psychopathologic symptoms, (3) response

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