Elsevier

Psychiatry Research

Volume 230, Issue 2, 15 December 2015, Pages 294-299
Psychiatry Research

Psychiatric comorbidity in women and men with eating disorders results from a large clinical database

https://doi.org/10.1016/j.psychres.2015.09.008Get rights and content

Abstract

Psychiatric comorbidity is common in patients with eating disorders (ED), but prevalence estimates are heterogeneous, probably due to methodological differences between studies (population, diagnostic method, sampling procedure etc.) and a few studies include men. The aim of this study is to investigate psychiatric DSM-IV Axis I comorbidity in a large sample of adult patients, both males and females, with the whole spectrum of DSM-IV ED diagnoses. Initial presentation assessment data on 11,588 adult men and women presenting to specialist ED clinics in Sweden between 2008 and 2012 were extracted from a large clinical database. Diagnostics were based on semi-structured interviews (SCID-I) and the Structured Eating Disorder Interview (SEDI). Seventy-one percent of the patients with ED had at least one other Axis I disorder. The most common type of diagnosis was anxiety disorders (53%), where generalized anxiety disorder was the most common diagnosis. The highest levels of comorbidity were found for women with Binge Eating Disorder (BED) and men with Bulimia Nervosa (BN). Findings are consistent with previous research showing a high prevalence of psychiatric comorbidity in both men and women with ED. The small gender differences observed seem negligible compared to the general similarity in comorbidity.

Section snippets

Background

Psychiatric comorbidity is common in patients with eating disorders (ED), and previous studies have reported a prevalence of 20–95% (Blinder et al., 2006, Buhren et al., 2014, Grilo et al., 2013, Herzog et al., 1992, Hudson et al., 2007, Kaye et al., 2004, Milos et al., 2004, Spindler and Milos, 2004, Zaider et al., 2000). Differences in estimates are most likely due to methodological differences between studies concerning, e.g., ED population, choice of diagnostic methodology (interviews,

Methods

Data in this study came from the Stepwise quality control database, a large-scale Internet based data collection system for specialized ED care. Criteria for inclusion in the database are medical or self-referral to one of the 35 participating treatment units, a diagnosed ED according to DSM-IV(American Psychiatric Association, 1994) and an intention to treat the patient at the unit in question (Birgegard et al., 2010). The database includes data from patients of all ages and both genders. In

Results

ED diagnostic distribution and demographic characteristics are shown in Table 1.The sample consists of 97% women and 3% men. In both men and women the AN patients (both ANR and ANBP) are the youngest in the sample and the BED patients are the oldest. No statistically significant differences according to age and BMI were observed between male and female ED patients according to our a priori rule of statistical and clinical significance.

Discussion

The aim of this study was to describe psychiatric Axis I comorbidity in a large sample of male and female ED patients. The results confirm that psychiatric comorbidity is common in both men and women. Few diseases have a gender distribution that is as skewed as ED, which raises the question if findings based on female samples can be generalized to male patients (Karlberg et al., 2002) into different aspect of illness. This gender division is true also for our study, with 97% female and 3% male

Conclusion

This study confirms previous results showing that comorbidity is high among patients with ED, and especially so in BED and BN. In summary, both men and women with ED suffer from a substantial degree of psychiatric comorbidity but men and women seem to be similar in our study in this regard.

Acknowledgment

This study was supported in part by a grant from the Stockholm County Council (ALF- medelgrant number 20130224) and grants from the Karolinska Institute. The Stepwise database is financially supported by Stockholm County Council.

References (27)

  • B.J. Blinder et al.

    Psychiatric comorbidities of female inpatients with eating disorders

    Psychosom. Med.

    (2006)
  • D.L. Braun et al.

    More males seek treatment for eating disorders

    Int. J. Eat. Disord.

    (1999)
  • K. Buhren et al.

    Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa

    Eur. Eat. Disord. Rev.

    (2014)
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