title: Risky drinking behaviors among women with eating disorders-A longitudinal community-based study.
abstract: Eating disorders and alcohol use disorders often co-occur, but few prospective studies have examined their relationship. Using a large population-based twin sample, we investigated how the drinking behaviors of women with lifetime eating disorders unfold from adolescence to adulthood.
  
  
  
  We identified 182 women with a lifetime eating disorder assessed at mean age 24, including 92 women with DSM-5 anorexia nervosa and 58 women with DSM-5 bulimia nervosa, from the 1975-1979 birth cohorts of Finnish twins (N = 2,825 women). Frequency of drinking and intoxicating were assessed at ages 16, 24, and 34. Drinking problems were assessed at ages 24 and 34 by the Malmö-modified Michigan Alcohol Screening Test (Mm-Mast) and the Rutgers Alcohol Problem Index (RAPI).
  
  
  
  At age 16, proportionately more women with eating disorders reported being severely intoxicated when they last drank (25% vs.16%, P = 0.001), and at both surveys in adulthood, they reported more frequent intoxication and more alcohol-related problems than their unaffected peers. Those who had recovered from their eating disorder at age 24 still reported more alcohol-related problems in their 30s than did other women. The age of drinking onset, number of monthly drinking days, or frequency of intoxication in adolescence did not differ between women with lifetime eating disorders and unaffected women.
  
  
  
  Women with eating disorders scored higher than their unaffected peers on scales measuring alcohol dependence, alcohol-related problems, and intoxication. These differences persisted from mid-adolescence into young adulthood. Women with eating disorders should be assessed routinely for drinking behaviors. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:563-571).
authors.affiliation: Department of Public Health, University of Helsinki, Finland.|Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland.
authors.forename: Linda
authors.initials: L
authors.lastname: Mustelin
authors.affiliation: Department of Public Health, University of Helsinki, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Latvala
authors.affiliation: Department of Public Health, University of Helsinki, Finland.|Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.|Institute of Clinical Medicine, Child Psychiatry, University of Turku, Finland.|National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Anu
authors.initials: A
authors.lastname: Raevuori
authors.affiliation: Department of Psychological & Brain Sciences, Indiana University, Bloomington, Indiana.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Rose
authors.affiliation: Department of Public Health, University of Helsinki, Finland.|Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland.|National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Kaprio
authors.affiliation: Department of Public Health, University of Helsinki, Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: Keski-Rahkonen
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D052018:Bulimia Nervosa / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D014427:Twins; D055815:Young Adult
keywords: alcohol use; co-morbidity; community-based study; eating disorders; epidemiology; longitudinal