The Clinical and Psychopathological Profile of Inpatients with Eating Disorders: Comparing Vomiting, Laxative Abuse, and Combined Purging Behaviors.

Background/objectives: The previous literature on purging behavior in eating disorders (EDs) suggests an overall more complicated clinical picture for individuals with this symptomatology. So far, no studies have analyzed the possible differences between the specific types of purging among ED inpatients.
Methods: A clinical sample of 302 inpatients with EDs was classified according to no purging behaviors, vomiting, the abuse of laxatives, and both vomiting and the abuse of laxatives. Participants completed the following questionnaires: the Eating Disorder Examination Questionnaire (EDE-Q), Frost Multidimensional Perfectionism Scale (F-MPS), State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). Clinical information was collected for each individual.
Results: Significant differences in the four groups were evidenced in age ( p < 0.001), years of illness ( p < 0.001), BMI at discharge ( p < 0.001), STAI state anxiety ( p < 0.001), STAI trait anxiety ( p < 0.001), BDI ( p < 0.001), EDE-Q eating concerns ( p < 0.001), EDE-Q shape concerns ( p < 0.001), EDE-Q weight concerns ( p < 0.001), EDE-Q global score ( p < 0.001), and F-MPS parental criticism ( p < 0.001). ED inpatients with purging behaviors were older, had a longer duration of illness, higher parental criticism, and worse general and eating psychopathology. No differences emerged between the specific types of purging behavior.
Conclusions: Purging behavior is a marker of severity in EDs independently of the specific type of purging. The appearance of any purging behavior must be regarded as a considerable red flag and be followed by an intensification of the cure.