Trastornos de personalidad en pacientes con desórdenes de la conducta alimentaria
Resumen
El interés por el estudio sistemático de los trastornos de personalidad en pacientes con desórdenes de la conducta alimentaria comienza con la aparición de la clasificación multiaxial del DSM III en 1980. Desde entonces numerosas publicaciones se han centrado principalmente en la prevalencia y efectos en el tratamiento de los trastornos de la personalidad en pacientes bulímicas y anoréxicas. Estos estudios han tenido resultados inconsistentes debidos, en buena medida, a divergencias conceptuales y metodológicas. En este artículo, se presentan las conclusiones más relevantes de dichas investigaciones, y se analizan las posibles fuentes de discrepancias. En términos generales, se puede afirmar que existe una comorbilidad moderada entre los trastornos de personalidad y los desórdenes de la conducta alimentaria. Los desórdenes más frecuentes son los trastornos borderline, histriónico, obsesivo- compulsivo, dependiente y evitativo de la personalidad. El trastorno borderline y el trastorno histriónico suelen presentarse con mayor frecuencia en la bulimia nerviosa, en tanto que el trastorno evitativo y el obsesivo compulsivo es más característico de la anorexia nerviosa. Sin embargo, el efecto de la relación entre trastornos de personalidad y de la conducta alimentaria en el tratamiento es aún poco clara, dando lugar a numerosas controversias e investigaciones.
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