Clarifying boundaries of binge eating disorder and psychiatric comorbidity: A latent structure analysis

IntroductionBinge-eating disorder (BED) is associated with obesity and with elevated rates of co-occurring major depressive disorder (MDD) but the significance of the diagnostic comorbidity is ambiguous—as is the significance of the onset sequence for MDD and BED.Objective and aimsWe compared eating-disorder psychopathology and psychiatric comorbidity in three subgroups of BED patients: those in whom onset of BED preceded onset of MDD, those with onset of MDD prior to onset of BED, and those without MDD or any psychiatric comorbidity.MethodsA consecutive series of 731 treatment-seeking patients meeting DSM-IV-TR research criteria for BED were assessed reliably by doctoral-clinicians with semi-structured interviews to evaluate lifetime psychiatric disorders (SCID-I/P) and ED psychopathology (EDE Interview).ResultsBased on SCID-I/P, 191 (26%) patients had onset of BED preceding onset of MDD, 114 (16%) had onset of MDD preceding onset of BED, and 426 (58%) had BED without co-occurring disorders. Three groups did not differ with respect to age, ethnicity, or education, but a greater proportion of the group without MDD was male. Three groups did not differ in body-mass-index or binge-eating frequency, but groups differed significantly with respect to eating-disorder psychopathology, with both MDD groups having significantly higher levels than the group without co-occurring disorders. The group having earlier onset of MDD had elevated rates of anxiety disorders compared to the group having earlier onset of BED.ConclusionsMDD in combination with BED—with either order of onset—has a meaningful adverse effect on ED psychopathology and overall psychiatric co-morbidity.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Association of binge eating disorder and psychiatric comorbidity in obese subjects [published erratum appears in Am J Psychiatry 1993 Dec;150(12):1910]

American Journal of Psychiatry ◽

10.1176/ajp.150.10.1472 ◽

1993 ◽

Vol 150 (10) ◽

pp. 1472-1479 ◽

Cited By ~ 153

Keyword(s):

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder ◽

Psychiatric Comorbidity ◽

Obese Subjects

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Treatment-seeking patients with binge-eating disorder in the Swedish national registers: clinical course and psychiatric comorbidity

BMC Psychiatry ◽

10.1186/s12888-016-0840-7 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 52

Author(s):

Elisabeth Welch ◽

Andreas Jangmo ◽

Laura M. Thornton ◽

Claes Norring ◽

Yvonne von Hausswolff-Juhlin ◽

...

Keyword(s):

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder ◽

Psychiatric Comorbidity ◽

Clinical Course ◽

Treatment Seeking

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Psychiatric comorbidity in a Brazilian sample of patients with binge-eating disorder

Psychiatry Research ◽

10.1016/s0165-1781(03)00127-6 ◽

2003 ◽

Vol 119 (1-2) ◽

pp. 189-194 ◽

Cited By ~ 36

Author(s):

Leonardo F. Fontenelle ◽

Mauro Vı́tor Mendlowicz ◽

Gabriela Bezerra de Menezes ◽

Marcelo Papelbaum ◽

Silvia R. Freitas ◽

...

Keyword(s):

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder ◽

Psychiatric Comorbidity ◽

Brazilian Sample

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Psychiatric Comorbidity in Binge-Eating Disorder as a Function of Smoking History

The Journal of Clinical Psychiatry ◽

10.4088/jcp.v67n0410 ◽

2006 ◽

Vol 67 (04) ◽

pp. 594-599 ◽

Cited By ~ 25

Author(s):

Marney A. White ◽

Carlos M. Grilo

Keyword(s):

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder ◽

Psychiatric Comorbidity ◽

Smoking History

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Prevalence of eating disorders and psychiatric comorbidity in a clinical sample of type 2 diabetes mellitus patients

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462005000200012 ◽

2005 ◽

Vol 27 (2) ◽

pp. 135-138 ◽

Cited By ~ 39

Author(s):

Marcelo Papelbaum ◽

José Carlos Appolinário ◽

Rodrigo de Oliveira Moreira ◽

Vivian Carola Moema Ellinger ◽

Rosane Kupfer ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Eating Disorders ◽

Type 2 Diabetes Mellitus ◽

Eating Disorder ◽

Anxiety Disorders ◽

Binge Eating ◽

Binge Eating Disorder ◽

Psychiatric Comorbidity

BACKGROUND: A few studies have shown high rates of eating disorders and psychiatric morbidity in patients with type 2 diabetes mellitus. OBJECTIVE: disturbed eating behavior and psychiatric comorbidity in a sample of T2DM patients. METHODS: Seventy type 2 diabetes mellitus patients between 40 and 65 years of age (mean, 52.9 ± 6.8) from a diabetes outpatient clinic were sequentially evaluated. The Structured Clinical Interview for DSM-IV, Binge Eating Scale and Beck Depression Inventory were used to assess eating disorders and other psychiatric comorbidity. In addition to the descriptive analysis of the data, we compared groups divided based on the presence of obesity (evaluated by the body mass index) or an eating disorder. RESULTS: Twenty percent of the sample displayed an eating disorder. Binge eating disorder was the predominant eating disorder diagnosis (10%). Overall, the group of obese patients with type 2 diabetes mellitus presented rates of psychiatric comorbidity comparable to those seen in their nonobese counterparts. However, the presence of an eating disorder was associated with a significant increase in the frequency of anxiety disorders (57.1% x 28.6%; p = 0.044). CONCLUSIONS: In our study sample, the occurrence of eating disorders was increased compared to rates observed in the general population, with the predominance of binge eating disorder. The presence of an eating disorder in type 2 diabetes mellitus patients was associated with higher rates of anxiety disorders.

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Psychiatric comorbidity as predictor and moderator of binge-eating disorder treatment outcomes: an analysis of aggregated randomized controlled trials

Psychological Medicine ◽

10.1017/s0033291721001045 ◽

2021 ◽

pp. 1-9

Author(s):

Janet A. Lydecker ◽

Carlos M. Grilo

Keyword(s):

Weight Loss ◽

Eating Disorder ◽

Binge Eating ◽

Treatment Outcomes ◽

Binge Eating Disorder ◽

Psychiatric Comorbidity ◽

Controlled Trials ◽

Eating Frequency ◽

Randomized Controlled ◽

Eating Disorder Psychopathology

Abstract Background Psychiatric comorbidity is common in binge-eating disorder (BED) but effects on treatment outcomes are unknown. The current study aimed to determine whether psychiatric comorbidity predicted or moderated BED treatment outcomes. Methods In total, 636 adults with BED in randomized-controlled trials (RCTs) were assessed prior, throughout, and posttreatment by doctoral research-clinicians using reliably-administered semi-structured interviews, self-report measures, and measured weight. Data were aggregated from RCTs testing cognitive-behavioral therapy, behavioral weight loss, multi-modal (combined pharmacological plus cognitive-behavioral/behavioral), and/or control conditions. Intent-to-treat analyses (all available data) tested comorbidity (mood, anxiety, ‘any disorder’ separately) as predictors and moderators of outcomes. Mixed-effects models tested comorbidity effects on binge-eating frequency, global eating-disorder psychopathology, and weight. Generalized estimating equation models tested binge-eating remission (zero binge-eating episodes during the past month; missing data imputed as failure). Results Overall, 41% of patients had current psychiatric comorbidity; 22% had mood and 23% had anxiety disorders. Psychiatric comorbidity did not significantly moderate the outcomes of specific treatments. Psychiatric comorbidity predicted worse eating-disorder psychopathology and higher binge-eating frequency across all treatments and timepoints. Patients with mood comorbidity were significantly less likely to remit than those without mood disorders (30% v. 41%). Psychiatric comorbidity neither predicted nor moderated weight loss. Conclusions Psychiatric comorbidity was associated with more severe BED psychopathology throughout treatment but did not moderate outcomes. Findings highlight the need to improve treatments for BED with psychiatric comorbidities but challenge perspectives that combining existing psychological and pharmacological interventions is warranted. Treatment research must identify more effective interventions for BED overall and for patients with comorbidities.

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