Gender issues in the management of multi-impulsive bulimia: a case-study.

We describe the management of multi-impulsive bulimia nervosa in a 27-year-old man. Inpatient treatment was attempted using a standardized focal-interpretative (psychodynamic) and cognitive-behavioral approach, with an emphasis on ward milieu. The value of this approach has been proved for female patients in the past. To our knowledge, this is the first report of its usage for a male with multi-impulsive bulimia, and the problems encountered highlight the impact of gender on behavioral symptoms, ward culture, and the predominantly female patient group.