ABSTRACT
To examine the relationship between drug abuse and eating disorders in a longitudinal sample. In a prospective study, women diagnosed with either DSM-IV anorexia nervosa (n = 136) or bulimia nervosa (n = 110) were interviewed and assessed for research diagnostic criteria drug use disorder (DUD) every 6-12 months over 8.6 years. Contrary to expectation, DUD did not influence recovery from either eating disorder. Multivariate analyses indicated that alcohol use and suicide attempts over the course of the study, as well as hospitalization for an affective disorder before the study, predicted DUD in anorexia nervosa. For bulimia nervosa, multivariate predictors included the severity of alcohol use and the severity of bulimic symptoms over the course of the study, and a hospitalization before study entry for a nonaffective disorder. Drug abuse in women with eating disorders is an area of clinical concern and should be monitored routinely.
Subject(s)
Feeding and Eating Disorders/complications , Feeding and Eating Disorders/psychology , Substance-Related Disorders/complications , Substance-Related Disorders/psychology , Adolescent , Adult , Diagnosis, Dual (Psychiatry)/methods , Diagnosis, Dual (Psychiatry)/psychology , Female , Humans , Interview, Psychological/methods , Longitudinal Studies , Predictive Value of Tests , Prospective StudiesABSTRACT
OBJECTIVE: Drug abuse in women with eating disorders has received relatively little attention. The frequency of drug use disorder (DUD) by specific drug type was examined in the current longitudinal study. METHOD: In a prospective study, women diagnosed with either anorexia nervosa (AN; n = 136) or bulimia nervosa (BN; n = 110), were interviewed and assessed for research diagnostic criteria (RDC) DUD every 6-12 months over 8.6 years. RESULTS: Forty-two (17%) women in the current longitudinal study had a lifetime history of DUD, with 19 prospective onsets over the course of the study (9 AN and 10 BN). The most commonly abused illicit drugs were amphetamines, cocaine, and marijuana, and rates of DUD did not differ between intake diagnoses of AN and BN. CONCLUSION: Drug abuse in women with eating disorders is an area of clinical concern and should be monitored routinely throughout the treatment process.
Subject(s)
Anorexia Nervosa/epidemiology , Bulimia/epidemiology , Illicit Drugs , Substance-Related Disorders/epidemiology , Adult , Amphetamine-Related Disorders/diagnosis , Amphetamine-Related Disorders/epidemiology , Amphetamine-Related Disorders/psychology , Anorexia Nervosa/diagnosis , Anorexia Nervosa/psychology , Boston , Bulimia/diagnosis , Bulimia/psychology , Cocaine-Related Disorders/diagnosis , Cocaine-Related Disorders/epidemiology , Cocaine-Related Disorders/psychology , Cross-Sectional Studies , Female , Humans , Interview, Psychological , Longitudinal Studies , Personality Assessment , Prospective Studies , Substance-Related Disorders/diagnosis , Substance-Related Disorders/psychologyABSTRACT
OBJECTIVE: Although eating disorders and alcohol use disorder (AUD) are known to co-occur, the influence of one on the other has not been studied. METHOD: In a prospective study, women diagnosed with either anorexia nervosa (AN; n = 136) or bulimia nervosa (BN; n = 110) were interviewed and assessed for Research Diagnostic Criteria (RDC) AUD every 6-12 months over 8.6 years. RESULTS: Over one fourth of the sample (n = 66 [27%]) reported a lifetime history of AUD. Ten percent of the study subjects (n = 24) developed AUD over the course of the study. AUD did not influence recovery from either eating disorder. Poor psychosocial functioning and history of substance use predicted prospective onset of an episode of AUD for both diagnostic groups. Unique predictors for AUD for women with AN were depression, overconcern with body image, and vomiting. Recovery from AUD was predicted by group therapy and hospitalization (women with AN) and individual therapy and exercise (women with BN). CONCLUSION: The influence of eating disorders on AUD appears to be greater than the reverse. A substantial number of patients who initially present with an eating disorder develop alcohol problems over the course of time, suggesting that the risk is an ongoing one that should be monitored by clinicians.
