Psychosomatic Medicine

Skip Navigation LinksHome > May/June 2006 - Volume 68 - Issue 3 > Psychiatric Comorbidities of Female Inpatients With Eating D...
Psychosomatic Medicine:
doi: 10.1097/01.psy.0000221254.77675.f5
Original Articles

Psychiatric Comorbidities of Female Inpatients With Eating Disorders

Blinder, Barton J. MD, PhD; Cumella, Edward J. PhD; Sanathara, Visant A. MD

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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.

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.

Copyright © 2006 by American Psychosomatic Society

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