A Register-Based Case-Control Study of Prescription Medication Utilization in Binge-Eating Disorder.
OBJECTIVE
Individuals with binge-eating disorder (BED) experience psychiatric and somatic comorbidities and obesity, but the nature and magnitude of prescription medication utilization is unclear. We investigated utilization using Swedish registry data and a case-control design.


METHODS
Cases were identified from Riksät and Stepwise longitudinal registers and were individuals diagnosed with BED per DSM-IV-TR criteria between July 1, 2006, and December 31, 2009, at eating disorder clinics (n = 238, 96% female, mean age = 22.8 years). For each case, 10 controls were matched on sex and year, month, and county of birth (n = 2,380). An index date was derived for each control, which was the date of diagnosis of BED in the corresponding case. The association between BED and prescription medication utilization was investigated before and within 12 months after diagnosis.


RESULTS
Before diagnosis, cases were significantly more likely than matched controls to have been prescribed nervous system (odds ratio = 6.4; 95% confidence limit = 4.7, 8.6), tumors and immune disorders (3.5; 1.3, 9.3), cardiovascular (2.2; 1.4, 3.5), digestion and metabolism (2.1; 1.5, 2.9), infectious diseases (1.9; 1.4, 2.6), skin (1.8; 1.3, 2.5), and respiratory system (1.3; 1.0, 1.8) medications. Cases also had higher odds of prescription use than controls across most categories within 12 months after diagnosis. Several associations were significant after accounting for lifetime psychiatric comorbidity and obesity.


CONCLUSIONS
Individuals with BED had increased utilization of psychiatric and nonpsychiatric medications compared with matched controls. Findings confirm that the illness burden of BED extends to high medication utilization and underscore the importance of thorough medication reviews when treating individuals with BED.
Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7160, 101 Manning Dr, Chapel Hill, NC 27599-7160. hunna_watson@med.unc.edu.|Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.|School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia.|School of Paediatrics and Child Health, The University of Western Australia, Perth.
Hunna J
HJ
Watson
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Andreas
A
Jangmo
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Melissa A
MA
Munn-Chernoff
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Laura M
LM
Thornton
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Elisabeth
E
Welch
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Camilla
C
Wiklund
Stockholm Centre for Eating Disorders, Sweden.|Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Yvonne
Y
von Hausswolff-Juhlin
Stockholm Centre for Eating Disorders, Sweden.|Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Claes
C
Norring
Shire, Lexington, Massachusetts, USA.
Barry K
BK
Herman
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Henrik
H
Larsson
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.|Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Cynthia M
CM
Bulik
D056912:Binge-Eating Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D055553:Prescription Drugs / Q000627:therapeutic use*; D015995:Prevalence; D012042:Registries; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
D055553:Prescription Drugs