Research Explores Comorbidities in Patients With Eating Disorders

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Researchers found a moderate prevalence of impulse control disorder (ICD) and behavioral addiction (BA) comorbidity in individuals with eating disorders (EDs) in a first-of-its-kind meta-analysis.

Because the prevalence of this comorbidity has never been systematically examined, Daniel J. Devoe, MSc PhD, and colleagues performed a series of random-effects meta-analyses of peer-reviewed literature reporting prevalence of ICDs or BAs in individuals with EDs. The investigators included 35 studies with a total of 9646 individuals who had an ED and analyzed the prevalence of different kinds of behavioral addictions among these individuals. The mean age of participants was 25.5 years (range 16.7 to 43.9), and 97.7% were female.¹

Results showed that stealing/shoplifting behaviors were the most common form of behavioral addictions in individuals with EDs, with a prevalence of 30%. Devoe et al also noted prevalence of pathological/compulsive buying at 19%, kleptomania at 18%, and pathological internet use at 12%. Intermittent explosive disorder, trichotillomania, and gambling had prevalence rates of 5%, 3%, and 2%, respectively.¹

Devoe and colleagues identified that ICDs are more closely associated with bulimia nervosa (BN) and binge-purge subtype (AN-BP) than other ED diagnoses and behaviors.This finding supported previous research indicating that individuals with binge-purge subtypes are more likely to struggle with ICDs, partly due to impulse control difficulties and greater emotion regulation. The researchers also noted that certain personality traits (eg, perfectionism, impulsivity), psychiatric comorbidity, age of onset (eg, early age of onset may worsen prognoses), and concurrent substance use disorders may also play a role in deteriorating ED prognoses. They also suggested that future research explore common underlying pathomechanisms.¹

“Although causal inferences cannot be drawn, the numbers strongly suggest that clinical screening/monitoring of ICDs/BAs should be part of the clinical routine in cohorts with EDs,” Devoe and colleagues concluded.

Reference

1. Devoe DJ, Anderson A, Bahji A, et al. The prevalence of impulse control disorders and behavioral addictions in eating disorders: a systematic review and meta-analysis. Front Psychiatry. 2022;12:724034.