This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Blinder, B. J. Articles by Sanathara, V. A. Search for Related Content PubMed PubMed Citation Articles by Blinder, B. J. Articles by Sanathara, V. A. Related Collections Anxiety Depression Eating Disorder

Psychiatric Comorbidities of Female Inpatients With Eating Disorders

From the Department of Psychiatry and Human Behavior, University of California, Irvine, California (B.J.B., V.A.S.); Research Department, Remuda Ranch Center for Anorexia and Bulimia, Wickenburg, Arizona (E.J.C.).

Address correspondence and reprint requests to Barton J. Blinder, MD, Department of Psychiatry and Human Behavior, University of California, Irvine, 400 Newport Center Drive, Newport Beach, CA 92660. E-mail: bblinder{at}uci.edu

Objective: We analyze 27 point-prevalent DSM-IV Axis I comorbidities for eating disorder inpatients.

Methods: The sample included 2436 female inpatients treated between January 1, 1995, and December 31, 2000, for primary DSM-IV diagnoses of anorexia, bulimia, and eating disorder not otherwise specified. Analyses were multivariate analysis of variance and multinomial logistic regression; sociodemographics and severity-of-illness measures were controlled.

Results: Ninety-seven percent of patients evidenced 1 comorbid diagnoses; 94% evidenced comorbid mood disorders, largely unipolar depression, with no differences across eating disorders; 56% evidenced anxiety disorders, with no differences across eating disorders; and 22% evidenced substance use disorders, with significant differences across eating disorders (p < .0001). Five specific diagnoses differed across eating disorders. Alcohol abuse/dependence was twice as likely with bulimia (p < .0001); polysubstance abuse/dependence three times as likely with bulimia (p < .0001); obsessive-compulsive disorder twice as likely with restricting and binge/purge anorexia (p < .01); posttraumatic stress disorder twice as likely with binge-purge anorexia (p < .05); schizophrenia/other psychoses three times more likely with restricting anorexia (p < .05) and two times with binge-purge anorexia (p < .05).

Conclusions: New findings emerged: extremely high comorbidity regardless of eating disorder, ubiquitous depression across all eating disorders, no difference in overall rate of anxiety disorders across eating disorders, greater posttraumatic stress disorder in binge-purge anorexia, more psychotic diagnoses in anorexia. Certain previous findings were confirmed: more obsessive-compulsive disorder in anorexia; more substance use in bulimia; and a replicated comorbidity rank-ordering for eating disorder patients: mood, anxiety, and substance use disorders, respectively.

Key Words: anorexia • bulimia • eating disorder • comorbid • co-occurring • Axis I

Abbreviations: ANB = anorexia nervosa, binge-eating/purging type; ANOVA = analysis of variance; ANR = anorexia nervosa, restricting type; BMI = body mass index; BN = bulimia nervosa; ED = eating disorder; EDNOS = eating disorder not otherwise specified; LOS = length of stay; MANOVA = multivariate analysis of variance; OCD = obsessive-compulsive disorder; PTSD = posttraumatic stress disorder; SUD = substance use disorder.

This article has been cited by other articles:

				C. Costa, E. Ramos, M. Severo, H. Barros, and C. Lopes Determinants of Eating Disorders Symptomatology in Portuguese Adolescents Arch Pediatr Adolesc Med, December 1, 2008; 162(12): 1126 - 1132. [Abstract] [Full Text] [PDF]