Comorbid drug use disorders and eating disorders: a review of prevalence studies

Abstract

AIMS – This study reviews literature on comorbidity of drug use disorders (DUD) and eating disorders (ED). The article updates knowledge on the occurrence of comorbidity of these diagnoses. METHODS – The databases Embase, Medline and PsycInfo were searched for studies published between 1990 and May 2011, with combinations of the terms ’eating disorder’, ’substance-related disorder’, ’drug dependence’, ’drug abuse’, ’drug addiction’ and ’substance abuse’. This generated altogether 596 studies. Studies in which diagnostic DUD and ED were not assessed in the same sample or the result was not given in percentages were excluded. Thirteen studies remained. RESULTS – In 11 of the 13 studies, the participants were initially diagnosed with an eating disorder. The prevalence of lifetime drug use disorders varies from 8–43 %. In two studies, DUD is the initial diagnosis, and the participants report 14 % concurrent and 27.3 % lifetime ED. The most prevalent co-occurring diagnoses tend to be bulimia nervosa/bingeing-purging anorexia nervosa, and stimulants/cannabis disorders. CONCLUSIONS – The lifetime prevalence percentages of eating disorders in people with drug use disorders (and vice versa) are higher than in the general population. The results indicate that the field of drug disorder treatment and research could benefit from paying closer attention to the risk of eating disorders. KEY WORDS – Drug use disorder, eating disorder, anorexia nervosa, bulimia nervosa, comorbidity, review article.