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Psychiatric symptomatology is clearly influenced by social factors. Such classical symptoms of the hysterical or conversion disorder as glove and stocking paralysis were once fairly widespread but appear today only in rather backward and poorly educated social groups throughout the world. Such a finding decidedly indicates social and educational causes. The purpose of this paper is to show that social and educational factors have also influenced obsessive-compulsive symptomatology; classical obsessive-compulsive neurosis has emerged today in a form involving food and disorders of eating. Among women of Western culture, the conditions known as anorexia nervosa and bulimia are the modern obsessive-compulsive disorders. First, social factors and individual diagnostic considerations, based on intensive long-term assessment of patients with these conditions, will be discussed. Then, results of a controlled diagnostic study of eating-disorder patients, also based on long-term observation, will be presented, and overall nosological implications discussed.
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