Eating disorder symptomatology and substance use disorders: prevalence and shared risk in a population based twin sample.
OBJECTIVE
Research shows a significant association between eating disorders (ED) and substance use disorders (SUD). The objective of this study is to examine the prevalence, chronology, and possibility of shared familial risk between SUD and ED symptomatology.


METHODS
Subjects included 1,206 monozygotic and 877 dizygotic adult female twins. ED symptomatology included anorexia (AN) and bulimia nervosa (BN) diagnosis, symptoms associated with diagnostic criteria, and BN symptom count. SUD included alcohol, illicit drug, and caffeine abuse/dependence. Generalized estimated equation modeling was used to examine phenotypic associations, and Choleksy decompositions were used to delineate the contribution of genes and environment to comorbidity.


RESULTS
There were no significant differences between SUD prevalence in women with AN and BN. Women with BN reported BN preceded SUD development while the reverse was true for AN. Twin analyses showed possible familial overlap between BN symptomatology and all SUD examined.


CONCLUSIONS
Results suggest an important difference in the chronology of EDs and SUDs. Women with BN may be turning to substances to dampen bulimic urges. Women with AN may be engaging in substance use initially in an effort to lose weight. Results also suggest familial factors contribute to the comorbidity between BN and SUD.
Baker
Jessica H
JH
Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Medical College of Virginia of Virginia Commonwealth University, Richmond, Virginia 23284, USA. bakerjh@mymail.vcu.edu
Mitchell
Karen S
KS
Neale
Michael C
MC
Kendler
Kenneth S
KS
D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D015897:Comorbidity; D004200:Diseases in Twins / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D005260:Female; D020022:Genetic Predisposition to Disease / Q000453:epidemiology*; D006801:Humans; D011159:Population Surveillance; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D011795:Surveys and Questionnaires; D014427:Twins