title: Comorbidity of mood and substance use disorders in patients with binge-eating disorder: Associations with personality disorder and eating disorder pathology.
abstract: OBJECTIVE
  Binge-eating disorder (BED) is associated with elevated rates of mood and substance use disorders, but the significance of such comorbidity is ambiguous. We compared personality disorder and eating disorder psychopathology in four subgroups of BED patients: those with mood disorders, those with substance use disorders, those with both, and those with neither.
  
  
  METHODS
  Subjects were 347 patients who met DSM-IV research criteria for BED. Semistructured interviews evaluated lifetime DSM-IV axis I disorders, DSM-IV personality disorder features, and eating disorder psychopathology.
  
  
  RESULTS
  Among these patients, 129 had co-occurring mood disorder, 34 had substance use disorder, 60 had both, and 124 had neither. Groups differed on personality disorder features, with those having mood disorder and both mood and substance use disorders showing the highest frequencies. Although groups did not differ in body mass index or binge eating frequency, they did differ on eating disorder psychopathology-with the groups having mood disorder and both comorbidities demonstrating higher eating, weight, and shape concerns. No differences were observed between groups with respect to ages of onset for specific eating behaviors, but some differences were observed for ages of disorder onset.
  
  
  CONCLUSIONS
  Mood and substance use disorders co-occur frequently among patients with BED. Compared with a previous work, the additional comparison group (those with both mood and substance use disorders) and the control group (those with neither) afforded better discrimination regarding the significance of these comorbidities. Our findings suggest approaches to subtyping BED based on psychiatric comorbidity, and may also have implications for treatment.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, USA. Electronic address: beckerdf@sutterhealth.org.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Becker
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Grilo
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D056912:Binge-Eating Disorder / Q000150:complications / Q000523:psychology*; D015992:Body Mass Index; D001835:Body Weight; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D039721:Diagnostic and Statistical Manual of Mental Disorders; D004435:Eating; D001068:Feeding and Eating Disorders / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications / Q000523:psychology*; D010554:Personality Disorders / Q000150:complications / Q000523:psychology*; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology*; D055815:Young Adult
keywords: Binge-eating disorder; Comorbidity; Depression; Diagnostic subtyping; Obesity; Substance use disorders