Mood spectrum comorbidity in patients with anorexia and bulimia nervosa

Purpose To investigate the presence of mood spectrum signs and symptoms in patients with anorexia nervosa, restricting subtype (AN-R) or bulimia nervosa (BN). Method 55 consecutive female patients meeting DSM-IV criteria for eating disorders (EDs) not satisfying DSM-IV criteria for Axis I mood disorders were evaluated with the Lifetime Mood Spectrum Self-Report (MOODS-SR) and the Mini-International Neuropsychiatric Interview (MINI). The MOODS-SR explored the subthreshold comorbidity for mood spectrum symptoms in patients not reaching the threshold for a mood disorder Axis I diagnosis. MOODS-SR included 161 items. Separate factor analyses of MOODS-SR identified 6 'depressive factors' and 9 'manic hypomanic factors'. Results The mean total score of MOODS-SR was significantly higher in BN than in AN-R patients (97.5 +/- 25.4 vs 61.1 +/- 38.5, respectively; p = 0.0001).63.6 % of the sample (n = 35) endorsed the threshold of >= 61 items, with a statistically significant difference between AN-R and BN (39.3 % vs 88.9 %; x(2) = 14.6; df = 1; p = 0.0001). Patients with BN scored significantly higher than AN-R patients on several MOODS-SR factors: (a) MOODS-SR depressive component: 'depressive mood' (11.2 +/- 7.4 vs 16.0 +/- 5.8; p < 0.05), 'psychomotor retardation' (5.4 +/- 5.6 vs 8.9 +/- 3.8; p = 0.003), 'psychotic features' (2.0 +/- 1.8 vs 4.1 +/- 1.6; p = 0.001), 'neurovegetative symptoms' (5.0 +/- 2.6 vs. Conclusions MOODS-SR identifies subthreshold mood signs/symptoms among patients with AN-R, and BN and with no Axis I comorbidity for mood disorders, and provides a better definition of clinical phenotypes.