BACKGROUND. Childhood sexual abuse (CSA) is found to have occurred
to a substantial minority of women with bulimia nervosa. Its clinical
significance is unclear. METHOD. We studied 87 bulimic women in a
clinical trial. Structured interviews determined the presence of CSA,
DSM-III-R disorders, global functioning, and depressive and bulimic
symptoms. RESULTS. Forty-four per cent reported a history of
CSA. Bulimic women with CSA reported earlier onset of bulimia, greater
depressive symptoms, worse global functioning and more suicide
attempts, and were more likely to meet criteria for bipolar II
disorder, alcohol and drug dependence, conduct disorder and avoidant
personality disorder. CONCLUSIONS. Although those with CSA had greater
comorbidity, it was not an important modifier of bulimic symptoms.