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Med."],"published-print":{"date-parts":[[1994,8]]},"abstract":"<jats:title>Synopsis<\/jats:title><jats:p>Thirty-two consecutively admitted females with bulimia nervosa (purging type) according to DSM-IV and additional impulsive behaviours (multi-impulsive bulimia (MIB)) and 32 age-matched female controls with DSM-IV bulimia nervosa (purging type) (uni-impulsive bulimia (UIB)) were assessed longitudinally on admission and at discharge following in-patient therapy and at a 2-year follow-up. Multi-impulsive bulimics were defined as presenting at least three of the six of the following impulsive behaviours in their life-time in addition to their bulimic symptoms at admission: (a) suicidal attempts, (b) severe autoaggression, (c) shop lifting (other than food), (d) alcohol abuse, (e) drug abuse, or (f) sexual promiscuity. Multi-impulsive bulimics were more frequently separated or divorced, had less schooling and held less-skilled jobs. Except for interoceptive awareness (EDI), which was more disturbed in multi-impulsive bulimics, there were no differences concerning scales measuring eating disturbances and related areas. Multi-impulsive bulimics showed more general psychopathology \u2013 anxiety, depression, anger and hostility, psychoticism \u2013 differed in several personality scales from uni-impulsive bulimics (e.g. increased excitability and anger\/hostility) and had overall a less favourable course of illness. Multi-impulsive bulimics also received more in- and out-patient therapy previous to the index treatment and during the follow-up period. The data support the notion that \u2018multi-impulsive bulimia\u2019 or \u2018multi-impulsive disorder\u2019 should be classified as a distinct diagnostic group on axis I or that an \u2018Impulsive Personality Disorder\u2019 should be introduced on axis II. The development of more effective treatment for multi-impulsive bulimia is warranted.<\/jats:p>","DOI":"10.1017\/s0033291700027744","type":"journal-article","created":{"date-parts":[[2009,7,9]],"date-time":"2009-07-09T13:59:18Z","timestamp":1247147958000},"page":"591-604","source":"Crossref","is-referenced-by-count":123,"title":["Course of multi-impulsive bulimia"],"prefix":"10.1017","volume":"24","author":[{"given":"M. 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