BINGE-EATING IN ANOREXIA-NERVOSA PREDICTS LATER ONSET OF SUBSTANCE USE DISORDER - A 10-YEAR PROSPECTIVE, LONGITUDINAL FOLLOW-UP OF 95 ADOLESCENTS

The cooccurrence of binge eating and increased alcohol intake and subs tance abuse has been reported in clinical and community epidemiologica l samples. To further investigate the nature and causes of this comorb idity, we examined the 10-year prospective, longitudinal course of ill ness in 95 nonsubstance abusing adolescents hospitalized for treatment of anorexia nervosa. Survival analysis with Cox regression was used t o quantitate the cumulative risk of developing substance use disorder (SUD) as a function of patterns of binge eating vs. dietary restraint within this cohort. Subjects who were binge eating at the time of inta ke were robustly distinguished from restrictors, having increased risk of SUD as well as greater likelihood of having at least one first-deg ree relative with SUD. The findings suggest binge eating that develops in the underweight stage of anorexia nervosa may reflect developmenta l, biological and genetic risk processes shared in common with SUD.