Psychotic phenomena in Binge Eating Disorder: an exploratory MMPI-2 study
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Crossing Dialogues Association
Massimiliano Aragona   

Crossing Dialogues Association, via Trapani 20, 00161 Rome, Italy
Submission date: 2014-11-25
Final revision date: 2015-04-14
Acceptance date: 2015-05-04
Publication date: 2015-09-01
Arch Psych Psych 2015;17(2):13–20
Aim of the study:
To study putative psychotic phenomena in patients with Binge Eating Disorder (BED).

Subject or material and methods:
Sixty patients with a DSM-5 diagnosis of BED were studied. Scores at the Sc, Pa and other subscales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were used to assess possible psychotic features. Eating phenomena were assessed by the Eating Disorder Inventory-2 (EDI-2). The relationship between them was studied.

Mean BMI was 38.24±8.43. The Sc and Pa scales of the MMPI-2 were above the cut-off in, respectively, 43.33% and 46.67% of patients. Regression analyses show that both Sc and Pa had a significant effect on EDI-2 scores, although only the Sc scale remained significant after adjusting for their possible interrelation. More than 40% of patients reported high scores (65 or more) at the following MMPI-2 “psychotic” subscales: Paranoia (Pa), Schizophrenia (Sc), Social Alienation (Sc1), Emotional Alienation (Sc2), and Lack of Ego Mastery, both cognitive and conative (Sc3 & Sc4). Perfectionism, Impulse Regulation, Ascetism, Social Insecurity, Interoceptive Awareness, Ineffectiveness, and Maturity Fears are the EDI-2 scales significantly influenced by the Sc and Pa MMPI-2 scores.

Several putative psychotic phenomena were reported in our sample of binge eaters, and they were related to higher scores on several dimensions of the EDI-2.

At least in some patients, there might be an overlap between some psychotic basic phenomena (disordered sense of basic Self, of bodily experiences, and hyperreflectivity), and those basic disturbances in identity development and Self-schemas which are at the base of eating disorders.