Present and lifetime comorbidity of tobacco, alcohol and drug use in eating disorders: a European multicenter study.
OBJECTIVE
To assess the differences in comorbid lifetime and current substance use (tobacco, alcohol and drug use) between eating disorder (ED) patients and healthy controls in five different European countries.


METHODS
A total of 1664 participants took part in the present study. ED cases (n=879) were referred to specialized ED units in five European countries. The ED cases were compared to a balanced control group of 785 healthy individuals.


RESULTS
Participants completed the Substance Use Subscale of the Cross Cultural (Environmental) Questionnaire (CCQ), a measure of lifetime tobacco, alcohol and drug use. In the control group, also the GHQ-28, the SCID-I interview and the EAT-26 were used.


RESULTS
ED patients had higher lifetime and current tobacco and general drug use. The only non-significant result was obtained for lifetime and current alcohol use. Significant differences across ED subdiagnoses and controls also emerged, with BN and AN-BP generally presenting the highest and AN-R and controls the lowest rates. The only exception was detected for alcohol use where EDNOS demonstrated the highest values. Only a few cultural differences between countries emerged.


CONCLUSIONS
With the exception of alcohol consumption, tobacco and drug use appear to be more prevalent in ED patients than healthy controls. The differential risk observed in patients with bulimic features might be related to differences in temperament or might be the result of increased sensitivity to reward.
Department of Psychiatry, Bellvitge University Hospital, Barcelona and Ciber Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto Salud Carlos III, Spain.
Isabel
I
Krug
Janet
J
Treasure
Marija
M
Anderluh
Laura
L
Bellodi
Elena
E
Cellini
Milena
M
di Bernardo
Roser
R
Granero
Andreas
A
Karwautz
Benedetta
B
Nacmias
Eva
E
Penelo
Valdo
V
Ricca
Sandro
S
Sorbi
Kate
K
Tchanturia
Gudrun
G
Wagner
David
D
Collier
Fernando
F
Fernández-Aranda
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology*; D001290:Attitude; D016022:Case-Control Studies; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D017831:Diagnosis, Dual (Psychiatry); D004435:Eating / Q000523:psychology; D005060:Europe / Q000453:epidemiology; D001068:Feeding and Eating Disorders / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D012931:Social Environment; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult