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Canadian Journal of Public Health

, Volume 96, Issue 2, pp 102–106 | Cite as

Substance Use Disorders, Anorexia, Bulimia, and Concurrent Disorders

  • Christine M. A. Courbasson
  • Patrick D. Smith
  • Patricia A. Cleland
Article

Abstract

Background

While the co-prevalence of eating disorders (ED) has been documented in individuals with substance use disorders (SUD), little is known about the co-occurrence of other disorders in this population. Examining this issue is critical for public health policy and treatment success.

Objective

To identify and evaluate the co-occurrence of ED and other psychiatric disorders in men and women with SUD.

Methods

The sample consisted of individuals seeking treatment for substance use. Semi-structured interviews and the CAMH Concurrent Disorders Screener were completed to assess DSM-IV psychopathology.

Results

Chi-square analyses suggested that more women scored positive for ED than men, EDs were more prevalent in both genders than in the general population, and the cooccurrence of other disorders was higher for clients with both SUD and ED than with SUD alone.

Discussion

Individuals with both SUD and ED appear to have multiple needs that may not be readily assessed by existing addiction treatment programs. Assessment issues, treatment, potential prevention and health promotion implications are addressed.

MeSH terms

Eating disorders substance-related disorders comorbidity 

Résumé

Contexte

La co-prévalence de troubles alimentaires (TA) est documentée chez les personnes ayan des problèmes d’abus d’alcool et de drogues (PAAD), cependant, on en sait peu sur la cooccurrence d’autres troubles dans ce segment de la population. Il est primordial d’étudier ce problème, car il est lié aux politiques de santé publique et à la réussite des traitements.

Objectif

Cerner et évaluer la co-prévalence des TA et d’autres troubles psychiatriques chez les hommes et les femmes ayant un PAAD.

Méthode

L’échantillon était constitué de personnes à la recherche d’un traitement pour une toxicomanie. Nous avons utilisé des entrevues structurées et l’outil CAMH Concurrent Disorders Screener pour évaluer toute psychopathologie relevant du DSM-IV.

Résultats

Les analyses du khi-carré ont révélé des taux plus élevés de TA chez les femmes que chez les hommes. La prévalence des TA était plus élevée chez les deux sexes que dans la population générale, et la co-occurrence d’autres troubles était plus élevée chez les personnes ayant à la fois un PAAD et un TA que chez celles qui n’avaient qu’un PAAD.

Discussion

Les personnes ayant un TA et un PAAD semblent avoir des besoins multiples qui ne sont pas évalués facilement par les programmes existants de traitement de la toxicomanie. Les questions d’évaluations, le traitement, la prévention possible, ainsi que les répercussions sur la promotion de la santé‚ sont abordés dans cet article.

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References

  1. 1.
    Goldbloom DS, Naranjo CA, Bremner KE, Hicks LK. Eating disorders and alcohol abuse in women. Br J Addict 1992;87:913–20.CrossRefPubMedGoogle Scholar
  2. 2.
    Garfinkel PE. Classification and diagnosis of eating disorders. In: Bronell J, Fairburn CG (Eds.), Eating disorders and obesity. New York: Guilford, 1995;125–34.Google Scholar
  3. 3.
    American Psychiatric Association (Ed.). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association, 2001.Google Scholar
  4. 4.
    Bulik CM. Drug and alcohol abuse by bulimic women and their families. Am J Psychiatry 1987;144:1604–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Hatsukami D, Eckert E, Mitchell JE, Pyle RL. Affective disorder and substance abuse in women with bulimia. Psychological Med 1984;14:701–4.CrossRefGoogle Scholar
  6. 6.
    Hudson JI, Pope HG Jr., Yurgelin-Todd D, Jonas JM, Frankengerg FR. A controlled study of lifetime prevalence of affective and other psychiatric disorders in bulimic outpatients. Am J Psychiatry 1987;144:1283–87.CrossRefPubMedGoogle Scholar
  7. 7.
    Mitchell JE, Hatsukami D, Eckert ED, Pyle RL. Characteristics of 275 patients with bulimia. Am J Psychiatry 1985;142:482–85.CrossRefPubMedGoogle Scholar
  8. 8.
    Pyle RL, Mitchell JE, Eckert ED. Bulimia: A report of 34 cases. J Clin Psychiatry 1981;42:60–64.PubMedGoogle Scholar
  9. 9.
    Hudson JI, Weiss RD, Pope HG Jr., McElroy SK, Mirin SM. Eating disorders in hospitalized substance abusers. Am J Drug Alcohol Abuse 1992;18(1):75–85.CrossRefPubMedGoogle Scholar
  10. 10.
    Jonas JM, Gold MS, Sweeney D, Pottash ALC. Eating disorders and cocaine abuse: A survey of 259 cocaine abusers. J Clin Psychiatry 1987;48:47–50.PubMedGoogle Scholar
  11. 11.
    Lacey JH, Moureli E. Bulimic alcoholics: Some features of a clinical sub-group. Br J Addiction 1986;81:389–93.CrossRefGoogle Scholar
  12. 12.
    Schuckit MA, Tipp JE, Anthenelli RM, Bucholz KK, Hesselbrock VM, Nurnberger UI Jr. Anorexia nervosa and bulimia nervosa in alcohol-dependent men and women and their relatives. Am J Psychiatry 1996;153(1):74–82.CrossRefPubMedGoogle Scholar
  13. 13.
    Peveler R, Fairburn C. Eating disorders in women who abuse alcohol. Br J Addiction 1990;85:1633–38.CrossRefGoogle Scholar
  14. 14.
    Zerbe KJ, Marsh SR, Coyne L. Comorbidity in an inpatient eating disordered population: Clinical characteristics and treatment implications. Psychiatric Hospital 1993;24:3–8.PubMedGoogle Scholar
  15. 15.
    Negrete JC, Collins J, Turner N, Skinner W. The CAMH Concurrent Disorders Screener. Accepted for publication in Can J Psychiatry.Google Scholar
  16. 16.
    Beckley-Barrett L (Speaker). Counselling the dysfunctional and non-compliant patient. [Audio tape]. American Dietetic Association; Annual meeting: 1988.Google Scholar
  17. 17.
    Corrigan SA, Johnson WG, Alford GS, Bergeron KC, Lemmon CR. Prevalence of bulimia among patients in a chemical dependency treatment program. Addict Behav 1990;15:581–85.CrossRefPubMedGoogle Scholar
  18. 18.
    Marcus RN, Katz J. Inpatient care of the substance-abusing patient with a concomitant eating disorder. Hospital and Community Psychiatry 1990;41:59–63.PubMedGoogle Scholar
  19. 19.
    Marcus MD. Binge eating and obesity. In: Bronell D, Fairburn CG (Eds.), Eating Disorders and Obesity: A Comprehensive Handbook. New York: Guilford, 1995;441–44.Google Scholar
  20. 20.
    Jonas JM. Eating disorders and alcohol and other drug abuse: Is there an association? Alcohol Health and Research World 1989;13:267–71.Google Scholar
  21. 21.
    Andersen AE. Eating disorders in males. In: Brownell, KD, Fairburn CG (Eds.), Eating Disorders and Obesity: A Comprehensive Handbook. New York: Guilford, 1995;177–82.Google Scholar
  22. 22.
    Sutherland LA, Weaver SN, McPeake JD, Quimby CD. The Beech Hill Hospital eating disorders treatment program for drug dependent females: Program description and case analysis. J Substance Abuse Treatment 1988;10(5):473–81.CrossRefGoogle Scholar
  23. 23.
    Bushnell JA, Wells JE, McKenzie M, Hornblow AR, Oakley-Browne MA, Joyce PR. Bulimia comorbidity in the general population and in the clinic. Psychological Med 1994;24:605–11.CrossRefGoogle Scholar
  24. 24.
    Telch CM, Stice E. Psychiatric comorbidity in women with binge eating disorder: Prevalence rates from a non-treatment-seeking sample. J Consult Clin Psychol 1998;66:768–76.CrossRefPubMedGoogle Scholar

Copyright information

© The Canadian Public Health Association 2005

Authors and Affiliations

  • Christine M. A. Courbasson
    • 1
    • 4
  • Patrick D. Smith
    • 2
  • Patricia A. Cleland
    • 3
  1. 1.Eating Disorders and Addictions ClinicCentre for Addiction and Mental HealthTorontoCanada
  2. 2.Clinical Programs, Centre for Addiction and Mental Health, Head, Addiction Psychiatry ProgramUniversity of TorontoCanada
  3. 3.Centre for Addiction and Mental HealthCanada
  4. 4.Addiction Psychiatry ProgramUniversity of TorontoCanada

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