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. 2010 Nov 1;43(7):648-58.
doi: 10.1002/eat.20856.

Eating disorder symptomatology and substance use disorders: prevalence and shared risk in a population based twin sample

Jessica H Baker  1 , Karen S Mitchell, Michael C Neale, Kenneth S Kendler
Affiliations
Free PMC article

Eating disorder symptomatology and substance use disorders: prevalence and shared risk in a population based twin sample

Jessica H Baker et al. Int J Eat Disord. .
Free PMC article

Abstract

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.

Method: 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.

Discussion: 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.

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Figures

FIGURE 1
FIGURE 1
Bivariate Cholesky decomposition. Notes: ED, eating disorder symptom; SUD, substance use disorder; A, additive genetic; C, shared environment; E, unique environment; a11, genetic path for ED; c11, shared environmental path for ED; e11, unique environmental path for ED; a12, genetic covariance between ED and SUD; c12, shared environmental covariance between ED and SUD; e12, unique environmental covariance between ED and SUD; a22, genetic path unique to SUD; c22, shared environmental path unique to SUD; e22, unique environmental path unique to SUD.
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