Co-Occurrence of Binge Eating Disorder With Psychiatric and Medical Disorders

Home | Subscribe to the Journal | Sign up for E-Lerts to your inbox

This entire article is available in PDF format to paid subscribers and for purchase (certain restrictions apply).
If you have not already registered for Full Text Access to The Journal, then visit our registration page.

Co-Occurrence of Binge Eating Disorder With Psychiatric and Medical Disorders

Kristin N. Javaras, D.Phil.; Harrison G. Pope, Jr., M.D.; Justine K. Lalonde, M.D.; Jacqueline L. Roberts, B.A.; Yael I. Nillni, B.A.; Nan M. Laird, Ph.D.; Cynthia M. Bulik, Ph.D.; Scott J. Crow, M.D.; Susan L. McElroy, M.D.; B. Timothy Walsh, M.D.; Ming T. Tsuang, M.D., Ph.D., Sc.D.; Norman R. Rosenthal, M.D.; and James I. Hudson, M.D., Sc.D.

Background: Prior studies suggest that certain psychiatric and medical disorders co-occur with binge eating disorder (BED). However, there has been no large, community-based study with diagnoses made by clinician interviewers. We used data from that type of study to assess the co-occurrence of various psychiatric and medical disorders with DSM-IV BED and with subthreshold BED.

Method: From October 2002 to July 2004, we interviewed 150 probands with BED, 150 probands without BED, and 888 of their first-degree relatives (135 of whom had BED, and 54 of whom met specific partial criteria for BED that we defined as subthreshold BED). Study participants were interviewed using the Structured Clinical Interview for DSM-IV to assess BED and other psychiatric disorders and a supplemental structured interview to assess certain medical disorders; participants also completed a self-report questionnaire, the Bad Things Scale. For each psychiatric and medical disorder, we calculated the age- and sex-adjusted co-occurrence odds ratio: the odds of having that disorder in one's lifetime among individuals with (full or subthreshold) lifetime BED compared to individuals without lifetime BED. We also used subjects' responses to the Bad Things Scale to adjust for adversity over-reporting, a type of response bias that could result in spurious findings of co-occurrence.

Results: Full BED co-occurred significantly with bipolar disorder, major depressive disorder, bulimia nervosa but not anorexia nervosa, most anxiety disorders, substance use disorders, body dysmorphic disorder, kleptomania, irritable bowel syndrome, and fibromyalgia. These results changed little after correcting for adversity over-reporting. Subthreshold BED co-occurred significantly with many, but not all, of the significantly co-occurring disorders for full BED.

Conclusion: BED and, to a lesser degree, subthreshold BED exhibit substantial lifetime co-occurrence with psychiatric and medical disorders.

(J Clin Psychiatry January 9, 2008: e1-e8; pii: ej07m03211)

Received March 12, 2007; accepted May 2, 2007. From the Department of Biostatistics, Harvard School of Public Health, Boston, Mass. (Drs. Javaras and Laird); the Department of Psychiatry, Harvard Medical School, and Biological Psychiatry Laboratory, McLean Hospital, Belmont, Mass. (Drs. Javaras, Pope, Lalonde, and Hudson and Mss. Roberts and Nillni); the Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill (Dr. Bulik); the Department of Psychiatry, University of Minnesota, Minneapolis (Dr. Crow); the Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr. McElroy); the Department of Psychiatry, Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York State Psychiatric Hospital, New York (Dr. Walsh); the Institute of Behavioral Genomics, Department of Psychiatry, University of California at San Diego and The Harvard Institute of Psychiatric Epidemiology & Genetics, Boston, Mass. (Dr. Tsuang); and Ortho-McNeil Pharmaceutical, Inc., Raritan, N.J. (Dr. Rosenthal). Dr. Lalonde is now with AstraZeneca, Zug, Switzerland.

The analysis presented here was supported by the National Institutes of Health Training Program in Psychiatric Epidemiology and Biostatistics (grant no. 5 T32 MN17119-22). The Boston family study was supported by a grant from Ortho-McNeil Pharmaceutical, Inc.

Presented in part at the 12th annual meeting of the Eating Disorders Research Society, September 1, 2006, Port Douglas, Australia.

Financial disclosure appears at the end of the article.

Corresponding author and reprints: Kristin N. Javaras, D.Phil., Waisman Center, 1500 Highland Ave., Madison, WI 53705 (e-mail:javaras@wisc.edu).

Home | Subscribe to the Journal | Sign up for E-Lerts to your inbox