Department of Psychology, McGill University, Montreal, Quebec, Canada.
Department of Psychology, University of British Columbia Okanagan, Kelowna, British Columbia, Canada.
Int J Eat Disord. 2022 Aug;55(8):993-1011. doi: 10.1002/eat.23731. Epub 2022 May 17.
Eating disorders and borderline personality disorder have high rates of comorbidity. However, the extent to which individual BPD symptoms are elevated in patients with EDs is largely unknown. Meta-analyses examined: (1) which of the nine BPD symptoms are especially elevated in individuals with versus without EDs, (2) whether particular ED subtypes have elevated levels of certain BPD symptoms, and (3) which BPD symptoms remain unstudied/understudied in relation to EDs.
We performed nine separate meta-analyses (one for each BPD symptom) to compare levels of symptoms in patients with EDs versus healthy controls. A total of 122 studies (range = 4-34 studies across symptoms) were included.
Affective instability was the BPD symptom most elevated, while anger was the BPD symptom least elevated, in patients with EDs compared to controls. When comparing effect sizes across ED subtypes, anorexia nervosa binge-eating/purging subtype had the largest effect sizes for the greatest number of BPD symptoms, while effect sizes for AN restrictive subtype were not significantly larger than those of other EDs for any BPD symptom. The least studied BPD symptoms were identity disturbance and interpersonal difficulties.
These meta-analyses suggest that certain symptoms of BPD play a more prominent role in the comorbidity between BPD and EDs than others. Targeting affective instability when treating cases of comorbid ED and BPD may be especially likely to ameliorate the negative outcomes related to this comorbidity. Future research should further investigate identity disturbance and interpersonal difficulties in the context of EDs.
Having an eating disorder and borderline personality disorder is a common comorbidity associated with a severe clinical presentation. BPD is characterized by nine distinct symptoms. This research examined levels of individual BPD symptoms in patients with versus without EDs. Findings can guide researchers and clinicians towards studying and treating symptoms that may be most relevant for BPD-ED comorbidity and in turn, improve outcomes for these patients.
饮食失调和边缘型人格障碍的共病率很高。然而，在患有 ED 的患者中，个体 BPD 症状的严重程度在很大程度上尚不清楚。荟萃分析考察了：（1）与没有 ED 的个体相比，哪些 BPD 症状在患有 ED 的个体中特别升高，（2）特定的 ED 亚型是否具有升高的特定 BPD 症状水平，以及（3）哪些 BPD 症状与 ED 相关仍未得到研究/研究不足。
我们进行了九项单独的荟萃分析（每项 BPD 症状一项），以比较 ED 患者与健康对照组之间症状的水平。共纳入 122 项研究（范围为每个症状 4-34 项研究）。
与对照组相比，情感不稳定是 ED 患者中 BPD 症状升高最明显的症状，而愤怒是 BPD 症状升高最不明显的症状。当比较 ED 亚型之间的效应大小时，神经性厌食症暴食/清除型具有最大数量的 BPD 症状的最大效应大小，而神经性厌食症限制型的效应大小对于任何 BPD 症状均不明显大于其他 ED。研究最少的 BPD 症状是身份障碍和人际困难。
这些荟萃分析表明，某些 BPD 症状在 BPD 和 ED 之间的共病中比其他症状更为突出。在治疗 ED 和 BPD 共病病例时，针对情感不稳定进行治疗可能特别有助于改善与这种共病相关的不良后果。未来的研究应进一步在 ED 背景下研究身份障碍和人际困难。
患有饮食失调和边缘型人格障碍是一种常见的共病，与严重的临床表现相关。BPD 有九个独特的症状。本研究检查了 ED 患者与没有 ED 的个体之间个体 BPD 症状的水平。研究结果可以为研究人员和临床医生提供指导，研究和治疗可能与 BPD-ED 共病最相关的症状，并最终改善这些患者的预后。
