Psychology

Instability of Diagnosis and Influence of Mental Health Issues on Eating Disorders
For many years people believed that eating disorders were only about girls, only about popular girls like teenagers that had everything going for them.  No one put together the fact that the action could be the symptom of underlying issues in both male and females.  The majority of people diagnosed with eating disorders are adolescence, or at least the onset begins during adolescence, and while a majority of the diagnoses are for females, male diagnoses are becoming more prevalent.

Instability of Eating Disorder Diagnosis
The research group of Milos, Spindler, Schnyder,  Fairburn (2005) conducted a study on three types of eating disorders anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified (EDNOS).  The basis of the study was to understand the diagnosis of eating disorders and to watch how the subjects would change in their diagnoses within a 30 month study timeframe.

The study had 192 female participants that continued with the study for the full 30 months.  The initial interview was given, then a follow up at 12 months and again at 30 months.  The dependent variables that were under investigation included remission, the changing from one type of eating disorder to another, forms of treatment for the disorder, and eating disorder behavior in particular purging.  The study was an applied and quantitative study in that the results could be applied to the field and to patients and the numbers of occurrences were especially important to understand the independent variable of the instability of the diagnoses of eating disorders (Milos, Spindler, Schnyder,  Fairburn 2005).

The results showed that there was low stability in the diagnosis of the eating disorders throughout the 30 months.  Some of this instability was due to remission.  However, the remission was also unstable due to the likelihood of a patient changing from one type of eating disorder to another instead of having a remission or after a remission (Milos, Spindler, Schnyder,  Fairburn 2005).

This study shows that the diagnosis of all eating disorders is extremely hard even for specialist within the eating disorder field.  This study did not focus on any other types of influences, but on the found that there were possible other influences in the diagnosis and understanding of eating disorders (Milos, Spindler, Schnyder,  Fairburn 2005).

Eating disorders in Patients diagnosed with Bipolar
This study was conducted in 2008 by J. E. Wildes, M. D. Marcus,  A Fagiolini and focused on the correlation of bipolar disorders on eating disorders.  The research used 81 subjects from the Bipolar Disorder Center for Pennsylvanians (BDCP).  The average age of the subjects was 43.1 with no significant differences in gender, marital situation and education.  The study included all types of bipolar disorder except for rapid cycling, and the eating disorder assessment had to be a factor for six months prior.

The study was a basic, qualitative study in that the numbers of occurrences were not as important and the reasons or possible reasons for the occurrences.  This was a basic instead of applied because it looked at the causes rather than the solutions of the problem. The study found that the variables of the rate of anxiety and other mental issues may also affect the onset of eating disorders, but the independent variable of bipolar disorder remained in each subject and their diagnosis so that other diagnoses were considered secondary to the bipolar (Wildes et al 2008)

The influence of the bipolar disorders was measured against dependent variables including the types of eating disorders to see which was the most influenced by the bipolar disorder.  The types of eating disorders included Binge Eating Disorder, Anorexia Nervosa and Bulima Nervosa.  The most commonly occurring disorder was the Binge Eating.  However, the other data showed that females were significantly more likely to be diagnoses with Anorexia Nervosa.  These finds support previous studies, but the fact remains that more work needs to be done in the field to gain a better understanding of the DSM-IV Axis I diagnoses influences on eating disorders (Wildes et al 2008).

Early Onset of Axis I Disorders with Diagnosis of Eating Disorders
In 2009, a group of researchers (Sihvola, Keski-Rahkonen, Dick, Hoek, Raevuori, Rose, Pulkkinen, Marttunen,  Kaprio) studied 1,318 twins in a five year period to see if there were any relationships between major depressive disorder (MDD), general anxiety disorder (GAD), as predictive to the onset of eating disorders.  The use of twins allowed for the researchers to control for demographics, and family situations.  The method of data collection was a researcherclinician interview of the twins at the age of 14, and a follow up of a self-administered survey at the age of 17.5 years of age.

Sihvola et al (2009) used a basic, qualitative study in that it the focus was on specific causes of eating disorders rather then on the number of occurrences.  While the number of occurrence was a minor factor the major variables were the diagnosis of MDD and GAD prior to the onset of the eating disorder, and then the reevaluation of the subject to analyze if there was any correlation between those two diagnoses and the diagnosis of some type of eating disorder.

The findings of this study showed that there was a definitive relationship between the onset of MDD and GAD at the age of 14 and the diagnosis of an eating disorder by the age of 17.5 years.  In fact the results showed that most anorexia diagnosis lasted the least amount of time, while bulimia was the second longest and binge eating lasted the longest of the eating disorders.  From these results it can be determined that there are other mitigating factors that create the onset of eating disorders.  While the findings are not conclusive, it does confirm that there is a need for continued studies of this type (Sihvola et al 2009).  

Conclusion
From these studies it seems to be clear that there are many factors that need to be understood as influential to the onset and diagnosis of any type of eating disorder.  The disorders themselves need to be studied more and better understood, but the fact that other DSM-IV Axis I disorders affect the eating disorders in such major ways, the studies must include other factors as well, such as bipolar disorder, MDD and GAD, as well as others.  It is obvious that eating disorders are not created on their own, but seem to be a symptom or reaction to other problems, and thus should be considered in such a way within studies about those other disorders as well.  It is not a singular direction, but both types of disorders seem to feed off one another, and need to be understood in relation to one another.