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Psychiatric disorders in women with bulimia nervosa and their first‐degree relatives: Effects of comorbid substance dependence
Author(s) -
Lilenfeld Lisa R.,
Kaye Walter H.,
Greeno Catherine G.,
Merikangas Kathleen R.,
Plotnicov Katherine,
Pollice Christine,
Rao Radhika,
Strober Michael,
Bulik Cynthia M.,
Nagy Linda
Publication year - 1997
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/(sici)1098-108x(199711)22:3<253::aid-eat4>3.0.co;2-m
Subject(s) - bulimia nervosa , psychiatry , eating disorders , substance use , psychology , comorbidity , first degree relatives , medicine , clinical psychology , family history
Objective Women with bulimia nervosa (BN) and comorbid substance dependence often display impulsive behaviors. We assessed Axis I and II psychiatric diagnoses in their first‐degree relatives in order to understand the etiological factors that may contribute to this subtype of BN. Method: We used contemporary family‐epidemiological methodology to compare the lifetime prevalence of psychiatric disorders among 47 women with BN and 44 non‐eating‐disordered community control women, and their first‐degree relatives (177 and 190, respectively). BN probands were stratified by the presence (n = 20) or absence (n = 27) of a lifetime history of alcohol and/or drug dependence. Results: Social phobia, conduct disorder, and clusters B and C personality disorders were significantly more prevalent among BN probands with substance dependence than among BN probands without substance dependence or control women probands. Substance use disorders, social phobia, panic disorder, and cluster B personality disorders were significantly more prevalent among the relatives of BN probands with substance dependence than the relatives of the other two groups. Discussion: Women with BN and substance dependence have problems with social anxiety, antisocial behavior, and a variety of personality disturbances, and come from families where there are problems with substance use disorders, anxiety, impulsivity, and affective instability. These data raise the possibility that a familial vulnerability for impulsivity and affective instability may contribute to the development of substance dependence in a subgroup of women with BN. © 1997 by John Wiley & Sons, Inc. Int J Eat Disord 22:253–264, 1997.