Presence of eating disorder symptoms in patients with obsessive-compulsive disorder

Abstract

Background: Obsessive-compulsive disorder (OCD) is common in patients with eating disorders (EDs). There is a lack of research investigating the presence of ED symptoms among patients with OCD, despite concerns that many of these patients may be at high risk for EDs. Our objective was to assess the presence of ED symptoms in patients receiving treatment for OCD.Methods: Adult patients with OCD (n = 132, 71% females) and controls (n = 260, 90% females) completed the Eating Disorder Examination-Questionnaire (EDE-Q) at admission to a specialized OCD outpatient unit. A small subset of patients (n = 22) also completed the EDE-Q 3-months after end of treatment.Results: At the group-level, mean EDE-Q scores did not differ significantly between female patients and controls. However, female patients compared to controls were significantly more likely to score above the EDE-Q cut-off (23% vs. 11%) and have a probable ED (9% vs. 1%), indicating elevated rates of ED symptoms in the clinical range. There was no evidence of elevated rates of ED symptoms in male patients, though sample sizes were small. Preliminary follow-up data showed that certain ED symptoms improved significantly from admission to 3-month follow-up.Conclusions: Our findings suggest that while ED symptoms are not generally elevated in female patients with OCD, a considerable subset of female patients may have a clinical ED or be at high risk of developing one. Clinicians should be alert to ED symptoms in female patients with OCD, and our findings raise the issue of whether ED screening of female patients with OCD is warranted.

Exploring the Relationship between Obsessive-compulsive Characteristics and Symptoms of Eating Disorders in a Nonclinical Population

“…The primary hypotheses of this investigation, that scores on self-report measures of obsessive-compulsive, anorexia, and bulimia symptoms would be positively correlated in a nonclinical sample, and that the relationship between obsessive-compulsive and anorexia symptoms would be higher than that between obsessive-compulsive and bulimia symptoms, were both supported. These finding coincide with trends in the clinical literature (Pigott et al, 1991;Thiel, Broocks, Ohlmeier, Jacoby, & Schüssler, 1995) generally, and specifically with observations detailing higher rates between OCD and Anorexia than Bulimia (Bang et. al., 2020;Jarry & Vaccarino, 1996;Levinson et.…”

“…Previous research has documented an elevated rate of comorbidity between the clinical diagnoses of Obsessive-Compulsive Disorder (OCD) and eating disorders, specifically Anorexia and Bulimia (Pigott et al, 1991;Thiel, Broocks, Ohlmeier, Jacoby, & Schüssler, 1995). Trends in these studies also suggest that OCD and obsessive symptoms appear to be more strongly associated with Anorexia than with Bulimia and that the comorbid presence of OCD among individuals with primary eating disorders is more common than the presence of an eating disorder in someone with primary OCD (Bang et. al., 2020;Jarry & Vaccarino, 1996;Levinson et.…”

Intolerance of uncertainty and maladaptive perfectionism as maintenance factors for eating disorders and obsessive‐compulsive disorder symptoms

“…Maintenance factors are identified among symptomatic samples (Stice, 2002), making a clinical sample of individuals with an ED appropriate for studying the maintaining factors of ED and OCD comorbidity. Individuals with EDs are more likely to be diagnosed with OCD compared to healthy controls (Kaye et al, 2004), and those with OCD report higher levels of ED symptoms compared to healthy controls (Bang et al, 2020 (Foa et al, 2002).…”

“…Maintenance factors are identified among symptomatic samples (Stice, 2002), making a clinical sample of individuals with an ED appropriate for studying the maintaining factors of ED and OCD comorbidity. Individuals with EDs are more likely to be diagnosed with OCD compared to healthy controls (Kaye et al, 2004), and those with OCD report higher levels of ED symptoms compared to healthy controls (Bang et al, 2020). Furthermore, as OCD is best conceptualised as a dimensional disorder (Mataix‐Cols, do Rosario‐Campos, & Leckman, 2005; McKay et al, 2004; Wheaton, Abramowitz, Berman, Riemann, & Hale, 2010), a clinical sample of EDs can shed light on how maladaptive perfectionism and IU maintain both ED and OCD symptoms.…”

Eating Disorders in Adolescence

“…OCD is frequently comorbid with EDs, with 20-60% of patients with EDs having a lifetime history of having OCD; OCD can also predict future development with anorexia. OCD rates are higher for females with 7-18% and 0%-5% for male patients; the patients included in those percentages have or had an ED (31).…”