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Vol. 72, No. 4, 2003
Issue release date: July–August 2003
Psychother Psychosom 2003;72:203–210
(DOI:10.1159/000070784)

Dropout from Brief Psychotherapy within a Combination Treatment in Bulimia nervosa: Role of Personality and Anger

Fassino S. · Abbate-Daga G. · Pierò A. · Leombruni P. · Rovera G.G.
Department of Neurosciences, Psychiatry Section, Service for Eating Disorders, Turin University, Turin, Italy

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Abstract

Background: To explore the personality, psychopathology, and clinical features of bulimic patients who do not complete psychotherapy, within a combined treatment. Methods: 86 patients with bulimia nervosa (BN; DSM-IV) were evaluated before beginning treatment. The Eating Disorder Inventory II (EDI-II), State-Trait Anger Expression Inventory (STAXI), and the Temperament and Character Inventory (TCI) were administered to all patients. Results: 3 subjects failed to engage in psychotherapy. Comparing patients who dropped out (n = 28) with those who did not drop out from psychotherapy (n = 55), significant differences were found in some psychopathologic (EDI-II, STAXI) and personality (TCI) variables. In particular, patients who dropped out from the treatment were more impulsive and more likely to feel anger; they were also less cooperative and less self-directive. No significant differences in sociodemographic, clinical variables and in response to fluoxetine were found between the two groups (dropout and completers). Conclusions: We found a characteristic profile in the bulimic patients who dropped out from brief psychotherapy, i.e., they are less cooperative and more predisposed to anger. These data suggest that dropping out in a subgroup of BN patients could be related to borderline personality traits and to difficulties in making and maintaining a therapeutic relationship. Implications for treatment are discussed.



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