Primary and secondary anorexia nervosa syndromes

The question of the specificity of anorexia nervosa is at present unsettled. Mayer-Gross et al. (8) describe it as a syndrome with its own particular psycho-physical characteristics, and others have drawn attention to consistencies in family history, personality and symptoms in series of cases (3, 10). But no statistically controlled study has confirmed its specificity, indeed the one such study of recent years, reported by Kay (6) and Kay and Leigh (7), concluded that there is no specific anorexia nervosa, that the label covers psychogenic anorexia occurring in a wide variety of psychiatric settings. This was a retrospective survey of a series of 37 patients diagnosed as suffering from anorexia nervosa in the past. It is possible that the lack of specificity might have been due to the imprecise definition implicit in such a sampling procedure. Although the study failed to demonstrate a specific anorexia nervosa, it did not finally refute the existence of such an entity.