Psychiatric co-morbidity in women presenting across the continuum of disordered eating

Abstract

Objective To compare the prevalence and correlates of psychiatric co-morbidity across a large sample of college women without an eating disorder, those at high risk for an eating disorder and women diagnosed using DSM-5 criteria for an eating disorder. Participants 549 college age women aged 18–25. Methods Data from the Eating Disorder Examination, the Structured Clinical Interview for DSM-IV Axis I disorders and self-report questionnaires were analyzed using logistic regression for categorical data and ANCOVA for continuous measures. Results Eating disordered symptomatology was strongly associated with anxiety disorders, mood disorders and insomnia. These co-morbidities (type and severity) tend to increase with eating disorder symptom severity. Conclusions Prevention and treatment programs for eating disorders need to address the high levels of mood, anxiety and sleep problems in this population. The findings on insomnia are novel and suggest that sleep disturbance may play an integral role in eating-related difficulties.

Behavioral and neurodevelopmental precursors to binge-type eating disorders: support for the role of negative valence systems

“…Yet, to our knowledge there is no biologically-driven conceptual model relating NVS-construct functioning to LOC-eating symptoms. Data on comorbidity between binge-type EDs and depressive or anxiety disorders (Swanson et al 2011, Aspen et al 2014) underscores the relevance of NVS to LOC-eating.…”

Medical Complications of Anorexia Nervosa and Bulimia

“…18 Eating disorders are strongly associated with mood and anxiety disorders, and the type and severity of these comorbidities is increased in patients who have the most severe eating disorders. [19][20][21][22][23] In addition, patients with bulimia nervosa who have comorbid borderline personality disorder have poorer outcomes than those without borderline personality M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT disorder when both groups are treated with psychotherapy and pharmacotherapy. 24,25 Psychiatric comorbidity, as well as a history of suicidal or self-harm ideation, and comorbid mental illnesses all confer an increased risk of death in patients with eating disorders.…”

Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses

“…Indeed, research has indicated that adults aged 18–29 years are more likely to develop obesity than individuals of older ages (Mokdad et al, 1999). Both EDs and obesity are associated with significant medical consequences and are commonly comorbid with psychiatric illnesses (Aspen et al, 2014; Balantekin, Birch, & Savage, 2015; Campbell & Peebles, 2014; Eddy et al, 2007; Glasofer et al, 2007; Goldschmidt, Aspen, Sinton, Tanofsky-Kraff, & Wilfley, 2008; National Heart Lung and Blood Institute, 2013; Rancourt & McCullough, 2015; Tanofsky-Kraff et al, 2007), are associated with impairment and stigmatization (Klump, Bulik, Kaye, Treasure, & Tyson, 2009; Puhl & Latner, 2007; Puhl & Suh, 2015), may interfere with academic achievement and impede academic outcomes (Krukowski et al, 2009), and result in high healthcare utilization and cost (Crow, 2014; Finkelstein, 2014). …”