Primary anorexia nervosa in the male and female: A comparison of clinical features and prognosis

Abstract

The clinical characteristics of a consecutive series of 36 male anorectics were compared with those of a similar series of 100 female cases. Social class background and mean age of onset were found to be similar as were the majority of clinical features at presentation. Anorexia nervosa was associated with diminished differences between the sexes in terms of physical, experimental and behavioural characteristics directly related to the condition, and in terms of general psychoneurotic characteristics. The condition is one within which the individual is sadly reduced to an existence rooted in the experience, behaviour and impulses of starvation including the impulse to ingest and the consequent defenses against this latter propensity and its implication of weight gain. Only the ''choice'' of defense relates to premorbid ''personality'' characteristics and thereby continues to characterize the individual. Overall the same background and presentation factors in both sexes predict similar outcomes, though a vomiting defense at presentation predicts good outcome for males and poor outcome for females. The condition is very rate in the male and such presentations may help to shed light on its overall nature.