title: Factors associated with substance use in adolescents with eating disorders.
abstract: OBJECTIVE
  To examine the prevalence and potential risk factors associated with substance use in adolescents with eating disorders (EDs).
  
  
  METHODS
  This cross-sectional study included 290 adolescents, aged 12-18 years, who presented for an initial ED evaluation at The Eating Disorders Program at the University of Chicago Medicine between 2001 and 2012. Several factors including DSM-5 diagnosis, diagnostic scores, and demographic characteristics were examined. Multinomial logistic regression was used to test associations between several factors and patterns of drug use for alcohol, cannabis, tobacco, and any other substance.
  
  
  RESULTS
  Lifetime prevalence of any substance use was found to be 24.6% in those with anorexia nervosa, 48.7% in bulimia nervosa (BN), and 28.6% in ED not otherwise specified. Regular substance use (monthly, daily, and bingeing behaviors) or a substance use disorder was found in 27.9% of all patients. Older age was the only factor associated with regular use of any substance in the final multinomial model. Older age and non-white race was associated with greater alcohol and cannabis use. Although binge-purge frequency and bulimia nervosa diagnosis were associated with regular substance use in bivariate analyses, gender, race, and age were more robustly associated with substance use in the final multinomial models.
  
  
  CONCLUSIONS
  Co-morbid substance use in adolescents with EDs is an important issue. Interventions targeting high-risk groups reporting regular substance use or substance use disorders are needed.
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois. Electronic address: andrea.mann@uchospitals.edu.
authors.forename: Andrea P
authors.initials: AP
authors.lastname: Mann
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois.
authors.forename: Erin C
authors.initials: EC
authors.lastname: Accurso
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Colleen
authors.initials: C
authors.lastname: Stiles-Shields
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois.
authors.forename: Lauren
authors.initials: L
authors.lastname: Capra
authors.affiliation: Department of Educational, School, and Counseling Psychology, University of Missouri, Columbia, Missouri.
authors.forename: Zandre
authors.initials: Z
authors.lastname: Labuschagne
authors.affiliation: Department of Psychiatry, Rush University Medical Center, Chicago, Illinois.
authors.forename: Niranjan S
authors.initials: NS
authors.lastname: Karnik
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois.
authors.forename: Daniel
authors.initials: D
authors.lastname: Le Grange
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D017677:Age Distribution; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Adolescents; Alcohol; Anorexia nervosa; Bulimia nervosa; Cannabis; DSM-5; Eating disorders; Substance use; Substance use disorder; Tobacco