Clinical severity of depression in eating disorders: A review

Pages: 1293-1298
Priya Bhatnagar and S. P. K. Jena (Department of Applied Psychology, university of Delhi South Campus, New Delhi)

The present paper attempts to review the clinical severity of depression in Eating Disorders (ED). ED involves extreme disturbances and deviations in eating behaviour. Depression as a clinical feature is closely associated with ED pathology. Anorexia Nervosa (AN) is characterized by enhanced levels of metacognitive capacities accompanied with a lack of positive beliefs. Aspects of self starvation assimilated with acute body image disturbance results in feeling of self loathing and distress. In the context of Bulimia Nervosa (BN), dysfunctional beliefs regarding weight and shape trigger binge and consequent compensatory behavior, forming the nucleus of the pathology. The vicious binge-purge cycle propelled with low levels of self esteem lead to emotional plunge and helplessness. In both the subtypes of ED, depressive features emerge as a core psychological component although magnitude is viewed to be higher in case of BN. The role of cognition lies common to the aetiology and maintenance of ED as well as depression. Inherent is a person’s tendency to make errors in judgment based on cognitive factors amalgamating issues related to self with negative beliefs. In addition, traumatic life events, personality factors such as narcissistic traits, internal locus of control and lack of self serving bias strongly determine the course of eating patterns and gravity of depression. As a result, maladaptive schemas are built towards ownself, world and future. Owing causation to the tilts in cognitive capacities, both the pathologies perhaps operate as cause and effect to each other. Hence it is well concluded that persistence of depression as core symptomatic manifestation is specific to ED pathology. Also, since cognition is of crucial importance in occurrence of ED and depression both, treatment targeting the cognitive dynamics is hypothesized to prove effective. Future research is recommended in the same and related areas.