ANOREXIA-NERVOSA AND BULIMIA-NERVOSA IN ALCOHOL-DEPENDENT MEN AND WOMEN AND THEIR RELATIVES

Objective: Many of the studies linking anorexia nervosa and bulimia ne rvosa to substance use disorders suffer from problems with small sampl es; some lack rigorous definitions of the syndromes, and it is difficu lt to determine whether eating problems were primarily temporary conse quences of heavy substance use or drugs were temporarily used in an ef fort to control appetite. The goal of this study was to evaluate the r elationship between alcohol dependence and eating disorders. Method: S tructured interviews were carried out with 2,283 women and 1,982 men a s part of the Collaborative Study on the Genetics of Alcoholism. Data on drug abuse and dependence, psychiatric disorders, and symptoms of a norexia and bulimia were evaluated among alcohol-dependent probands, t heir relatives, comparison probands, and their relatives. Results: Lif etime rates for anorexia and bulimia were 1.41% and 6.17%, respectivel y, for the alcohol-dependent women, and bulimia was observed in 1.35% of the alcoholic men. However, once the impact of additional primary d iagnoses was controlled for, anorexia was seen in only 1.26% of the wo men with primary alcohol dependence and none of-the alcohol-dependent men; the rates for bulimia were 3.46% and 0.72%, respectively. There w as no evidence of a strong familial crossover between alcohol dependen ce and anorexia or bulimia. Conclusions: While the rate of anorexia wa s not elevated in alcoholics after controlling for other disorders, bu limia did occur at a greater than expected rate. However, both eating disorders were relatively rare, and much of the association with alcoh olism occurred in the context of additional preexisting or secondary p sychiatric disorders.