Thoughts on the 25th anniversary of bulimia nervosa

摘要

My original article on bulimia nervosa appeared in the August 1979 issue of Psychological Medicine. It is timely to examine whether the description of this new disorder and the formulated diagnostic criteria have stood the test of time. A similar question is whether it was right to describe the new syndrome as an ominous variant of anorexia nervosa. The answers to these questions should really be given by other investigators. My own view is that the main clinical description and the diagnostic criteria of bulimia nervosa have proved reasonably robust, as has its close relationship to anorexia nervosa. On the other hand, my view about the ominous nature of bulimia nervosa was unduly pessimistic. The original description of bulimia nervosa had a significant impact on the clinical and scientific literature, which showed an accelerated growth during the 1980s, largely due to articles on bulimia and bulimia nervosa. The historical question Is bulimia nervosa a new disorder? has hitherto been neglected. The evidence for answering this question in the affirmative is very strong and is derived from searches of the older psychiatric literature as well as more recent cohort studies which throw light on when the new syndrome burst from the blue upon modern society.