Tuesday, February 19, 2019

Substance Use Disorder, Borderline Personality Disorder Common in Patients With Eating Disorders

More than half of patients with eating disorders have at least one other psychiatric condition such as substance use disorder (SUD) or borderline personality disorder, suggests a study in the International Journal of Eating Disorders. In addition, symptoms of eating disorders are more severe in those who have either SUD or borderline personality disorder.

Thomas J. Weigel, M.D., of McLean Hospital in Belmont, Mass., and colleagues analyzed the records of 479 patients who were in a residential treatment program for an eating disorder for at least 30 days between mid-November 2010 and mid-September 2014. Patients completed surveys to screen for SUDs and borderline personality disorder when they entered treatment. They also took the Eating Disorder Examination-Questionnaire (EDE-Q)—which evaluates the severity and frequency of eating disorder symptoms—when they entered treatment and every two weeks until they were discharged.

The researchers found that 55% of the patients with an eating disorder screened positive for SUD and/or borderline personality disorder when entering treatment. Among all patients, 41.3% screened positive for SUD, 33.2% screened positive for borderline personality disorder, and 19.4% screened positive for both. Furthermore, those with another condition in addition to an eating disorder had higher scores on the EDE-Q.

The researchers also tracked how the patients’ eating disorder symptoms changed as treatment progressed. They found that symptoms improved faster for patients with SUD than for patients with borderline personality disorder or an eating disorder without any other conditions.

“Abstinence from substances may diminish their adverse mood and food intake effects, both of which contribute to ED symptoms,” Weigel and colleagues wrote.

In addition, symptoms improved faster for patients with both SUD and borderline personality disorder than for patients with borderline personality disorder.

“This is perhaps because while access to substances is removed in residential treatment, [borderline personality disorder] symptoms represent chronic cognitive and behavioral patterns, such that participants are likely to remain symptomatic of [borderline personality disorder] during residential care,” they added.

The researchers noted a few limitations to their study, notably that it was conducted in only one treatment program and that they did not have information about the patients’ eating disorder diagnoses.

For related information, see the Psychiatric News article “Brief Update and Review on Treating Eating Disorders.”

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