This study reviews literature on comorbidity of drug use disorders (DUD) and eating disorders (ED). The article updates knowledge on the occurrence of comorbidity of these diagnoses.
Methods
The databases Embase, Medline and PsycInfo were searched for studies published between 1990 and May 2011, with combinations of the terms ‘eating disorder’, ‘substance-related disorder’, ‘drug dependence’, ‘drug abuse’, ‘drug addiction’ and ‘substance abuse’. This generated altogether 596 studies. Studies in which diagnostic DUD and ED were not assessed in the same sample or the result was not given in percentages were excluded. Thirteen studies remained.
Results
In 11 of the 13 studies, the participants were initially diagnosed with an eating disorder. The prevalence of lifetime drug use disorders varies from 8–43 %. In two studies, DUD is the initial diagnosis, and the participants report 14 % concurrent and 27.3% lifetime ED. The most prevalent co-occurring diagnoses tend to be bulimia nervosa/bingeing-purging anorexia nervosa, and stimulants/cannabis disorders.
Conclusions
The lifetime prevalence percentages of eating disorders in people with drug use disorders (and vice versa) are higher than in the general population. The results indicate that the field of drug disorder treatment and research could benefit from paying closer attention to the risk of eating disorders.
BakerJ.H., & MazzeroS.E., & KendlerK.S. (2007): Association between broadly defined bulimia nervosa and drug use disorders: Common genetic and environmental influences.International Journal of Eating Disorders40: 673–678
2.
BlinderB.J., & CumellaE.J., & SanatharaV.A. (2006): Psyciatric comorbidity of female inpatients with eating disorders.Psycho-somatic Medicine68: 454–462
BushnellJ.A., & WellsJ.E., & McKenzieJ.M., & HornblowA.R., & Oakley-BrowneM.A., & JoyceP.R. (1994): Bulimia comorbidity in the general population and in the clinic.Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences24(3): 605–611
5.
Calero-ElviraA., & KrugI., & DavisK., & LopezC., & Fernandez-ArandaF., & TreasureJ. (2009): Meta-analysis on drugs in people with eating disorders.European Eating Disorders Review17(4): 243–259
6.
CarbaughR.J., & SiasS.M. (2010): Comorbidity of bulimia nervosa and substance abuse: Etiologies, treatment issues, and treatment approaches.Journal of Mental Health Counseling32(2): 125–138
7.
Castro-FornielesJ., & DíazR., & GotiJ., & CalvoR., & GonzalezL., & SerranoL., & GualA. (2010): Prevalence and factors related to substance use among adolescents with eating disorders.European Addiction Research16: 61–68
8.
CohenL.R., & GordonS.M. (2009): Co-occurring eating and substance use disorders. In: BradyK.T., & BackS.E., & GreenfieldS.P. (eds.): Women and Addiction. A comprehensive handbook.New York: The Guilford Press
9.
CochraneC., & MalcolmR., & BrewertonT. (1998): The role of weight control as a motivation for cocaine abuse.Addictive Behaviors23(2): 201–207
10.
CourbassonC.M., & MclaughlinP.M., & LetchumananM., & WongB.I. (2010): Substance use disorders in adolescents with eating disorders.Minerva Psichiatrica51(3): 177–189
11.
CowanJ., & DevineC. (2008): Food, eating, and weight concerns of men in recovery from substance addiction.Appetite50(1): 33–42
12.
CurranH.V., & RobjantK. (2006): Eating attitudes, weight concerns and beliefs about drug effects in women who use ecstasy.Journal of Psychopharmacology20(3): 425–431
13.
DohmF.A., & Striegel-MooreR.H., & WilfleyD.E., & PikeK.M., & HookJ., & FairburnC.G. (2002): Self-harm and substance use in a community sample of black and white women with binge eating disorder or bulimia nervosa.International Journal of Eating Disorders32(4): 389–400
14.
DSM-IV-TR (2000): Diagnostic and statistical manual of mental disorders. Fourth edition. Text revision.Washington DC: American Psychiatric Association
15.
EMCDDA (2010): Annual report 2010: The state of the drugs problem in Europe.Lisbon: European Monitoring Centre for Drugs and Drug Addiction
16.
GordonS.M., & JohnsonJ.A., & GreenfieldS.F., & CohenL., & KilleenT., & RomanP.M. (2008): Assessment and treatment of co-occurring eating disorders in publicly funded addiction treatment programs.Psychiatric Services59(9): 1056–1059
17.
GriloC.M., & WhiteM.A., & MashebR.M. (2009): DSM-IV psychiatric disorder comorbodity and its correlates in binge eating disorder.International Journal of Eating Disorders42: 228–234
18.
HarropE.N., & MarlattG.A. (2010): The comorbidity of substance use disorders and eating disorders in women: Prevalence, etiology, and treatment.Addictive Behaviors35(5): 392–398
19.
HerzogD.B., & FrankoD.L., & DorerD.J., & KeelP.K., & JacksonS., & ManzoM.P. (2006): Drug abuse in women with eating disorders.International Journal of Eating Disorders39(5): 364–368
20.
HodgkinsC.C., & JacobsW.S., & GoldM.S. (2003): Weight gain after adolescent drug addiction treatment and supervised abstinence.Psychiatric Annals33(2): 112–116
21.
HoldernessC.C., & Brooks-GunnJ., & WarrenM.P. (1994): Comorbidity of eating disorders and substance abuse – review of the literature.International Journal of Eating Disorders16(1): 1–34
22.
HudsonJ.I., & WeissR.D., & PopeH.G.Jr, & McElroyS.K., & MirinS.M. (1992): Eating disorders in hospitalized substance abusers.American Journal of Drug and Alcohol Abuse18(1): 75–85
23.
JordanJ., & JoyceP.R., & CarterF.A., & HornJ., & McIntoshV.V.W., & LutyS.E.E., & McKenzieJ.M., & MulderR.T., & BulikC.M. (2003): Anxiety and psychoactive substance use disorder comorbidity in anorexia nervosa or depression.International Journal of Eating Disorders34(2): 211–219
24.
KesslerR.C., & BerglundP., & DemlerO., & JinR., & Merikangas,KR., & WaltersE.E. (2005): Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.Archives of General Psychiatry62: 593–602
25.
KesslerR.C., & McGonagleK.A., & ZhaoS., & NelsonC.B., & HughesM., & EshlemanS., & WittchenH.A., & KendlerK.S. (1994): Lifetime and 12-months prevalence of DSM-II-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.Archives of General Psychiatry51: 8–19
26.
KilleenT.K., & GreenfieldS.F., & BrideB.E., & CohenL., & GordonS.M., & RomanP.M. (2011): Assessment and treatment of co-occurring eating disorders in privately funded addiction treatment programs.American Journal on Addictions20(3): 205–211
27.
KrahnD. (1993): The relationship of eating disorders and substance abuse. In: GombergE.S.L., & NirenbergT.D. (eds.): Women and substance abuse.Stamford, CT: Ablex Publishing
28.
LaceyJ.H. (1993): Self-damaging and addictive behaviour in bulimia nervosa: A catchment area study.British Journal of Psychiatry163: 190–194
29.
MiljkovitchR., & PierrehumbertB., & KarmaniolaA., & BaderM., & HalfonO. (2005): Assessing attachment cognitions and their associations with depression in youth with eating or drug misuse disorders.Substance Use and Misuse40(5): 605–623
30.
NagataT., & KawaradaY., & OhshimaJ., & IketaniT., & KiriikeN. (2002): Drug use disorders in Japanese eating disorder patients.Psychiatry Research109: 181–191
31.
NealeA., & AbrahamS., & RussellJ. (2009): “Ice” use and eating disorders: A report of three cases.International Journal of Eating Disorders42: 188–191
32.
NewmanM.M., & GoldM.S. (1992): Preliminary findings of patterns of substance abuse in eating disorder patients.American Journal of Drug & Alcohol Abuse18(2): 207–211
33.
O'BrianK.M., & VincentN.K. (2003): Psychiatric comorbidity in anorexia and bulimia nervosa: nature, prevalence, and casual relationships.Clinical Psychology Review23(1): 57–74
34.
PeatC., & MitchellJ.E., & HoekH.W., & WonderlichS.A. (2009): Validity and utility of subtyping anorexia nervosa.International Journal of Eating Disorders42: 590–594
35.
PiranN., & RobinsonS.R. (2006): Associations between disordered eating behaviors and licit and illicit substance use and abuse in a university sample.Addictive Behaviors31(10): 1761–1775
36.
RodondiN., & PletcherM.J., & LiuK., & HulleyS.B., & SidneyS. (2006): Marijuana use, diet, Body Mass Index, and cardiovascular risk factors.American Journal of Cardiology98(4): 478–484
37.
RootT.L., & PinheiroA.P., & ThorntonL., & StroberM., & Fernandez-ArandaF., & BrandtH., & CrawfordS., & FichterM.M., & HalmiK.A., & JohnsonC., & KaplanA.S., & KlumpK.L., & La ViaM., & MitchellJ., & WoodsideD.B., & RotondoA., & BerrettiniW.H., & KayeW.H., & BulikC.M. (2010a): Substance use disorders in women with anorexia nervosa.International Journal of Eating Disorders43: 14–21
38.
RootT.L., & PisetskyE.M., & ThorntonL., & LichtensteinP., & PedersenN.L., & BulikC.M. (2010b): Patterns of comorbidity of eating disorders and substance abuse in Swedish females.Psychological Medicine40: 105–115
39.
SAMHSA (2009): Results from the 2008 National Survey on Drug Use and Health: National Findings.Rockville, Maryland: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration
40.
SyskoR., & HildebrandtT. (2009): Cognitive-behavioural therapy for individuals with bulimia nervosa and a co-occurring substance use disorder.European Eating Disorders Review17(2): 89–100
41.
Thompson-BrennerH.K., & EddyT., & FrankoD.L., & DorerD., & VashchenkoM., & HerzogD.B. (2008): Personality pathology and substance abuse in eating disorders: A longitudinal study.International Journal of Eating Disorders41: 203–208
42.
WalfishS., & StenmarkD.E., & SarcoD., & ShealyJ.S., & KroneA.M. (1992): Incidence of bulimia in substance misusing women in residential treatment.International Journal of the Addictions27(4): 425–433
43.
WolfeW.L., & MaistoS.A. (2000): The relationship between eating disorders and substance use: Moving beyond co-prevalence research.Clinical Psychology Review20(5): 617–631.
