title: Association between broadly defined bulimia nervosa and drug use disorders: common genetic and environmental influences.
abstract: OBJECTIVE
  Previous research has shown an association between bulimia (BN) and drug use disorders (DUD). The purpose of the present study was to investigate possible influences on the comorbidity between BN and DUD.
  
  
  METHODS
  Participants included 490 monozygotic and 354 dizygotic female twins and 930 females from opposite sex pairs. Multiple logistic regression analyses were used to test shared correlates and mediators. Bivariate twin analyses were used to investigate the contribution of genes and environment to the correlation between BN and DUD.
  
  
  RESULTS
  Depression, neuroticism, and childhood sexual abuse (CSA) mediated the association between BN and DUD regardless of which disorder was used as the dependent variable. Analyses also indicated genetic and nonshared environmental overlap between BN and DUD.
  
  
  CONCLUSIONS
  The association between BN and DUD is due mostly to overlapping genetic influences with a smaller contribution from nonshared environment. Depression, neuroticism, and CSA are likely important shared correlates.
authors.affiliation: Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, USA. bakerjh@vcu.edu
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Baker
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Mazzeo
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Kendler
mesh_terms: D000328:Adult; D052018:Bulimia Nervosa / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D004200:Diseases in Twins / Q000235:genetics* / Q000523:psychology; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009497:Neurotic Disorders / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D012307:Risk Factors; D012931:Social Environment; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology; D014429:Twins, Dizygotic / Q000235:genetics / Q000523:psychology; D014430:Twins, Monozygotic / Q000235:genetics / Q000523:psychology