Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

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

Authors: Elisabeth Welch, Andreas Jangmo, Laura M. Thornton, Claes Norring, Yvonne von Hausswolff-Juhlin, Barry K. Herman, Manjiri Pawaskar, Henrik Larsson, Cynthia M. Bulik

Published in: BMC Psychiatry | Issue 1/2016

Login to get access

Abstract

Background

We linked extensive longitudinal data from the Swedish national eating disorders quality registers and patient registers to explore clinical characteristics at diagnosis, diagnostic flux, psychiatric comorbidity, and suicide attempts in 850 individuals diagnosed with binge-eating disorder (BED).

Method

Cases were all individuals who met criteria for BED in the quality registers (N = 850). We identified 10 controls for each identified case from the Multi-Generation Register matched on sex, and year, month, and county of birth. We evaluated characteristics of individuals with BED at evaluation and explored diagnostic flux across eating disorders presentations between evaluation and one-year follow-up. We applied conditional logistic regression models to assess the association of BED with each comorbid psychiatric disorder and with suicide attempts and explored whether risk for depression and suicide were differentially elevated in individuals with BED with or without comorbid obesity.

Results

BED shows considerable diagnostic flux with other eating disorders over time, carries high psychiatric comorbidity burden with other eating disorders (OR 85.8; 95 % CI: 61.6, 119.4), major depressive disorder (OR 7.6; 95 % CI: 6.2, 9.3), bipolar disorder (OR 7.5; 95 % CI: 4.8, 11.9), anxiety disorders (OR 5.2; 95 % CI: 4.2, 6.4), and post-traumatic stress disorder (OR 4.3; 95 % CI: 3.2, 5.7) and is associated with elevated risk for suicide attempts (OR 1.8; 95 % CI: 1.2, 2.7). Depression and suicide attempt risk were elevated in individuals with BED with and without comorbid obesity.

Conclusions

Considerable flux occurs across BED and other eating disorder diagnoses. The high psychiatric comorbidity and suicide risk underscore the severity and clinical complexity of BED.
Literature
1.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition. Arlington: American Psychiatric Association; 2013.CrossRef
2.
Kessler RC, Berglund PA, Chiu WT, Deitz AC, Hudson JI, Shahly V, et al. The prevalence and correlates of binge eating disorder in the World Health Organization World Mental Health Surveys. Biol Psychiatry. 2013;73(9):904–14.CrossRefPubMedPubMedCentral
3.
Crossow N, Pawaskar, M, Witt, EA, Ming, EE, Victor, TW, Herman, BK, Wadden, TA, Haim Erder, M. Estimating the prevalence of binge eating disorder in a community sample: Comparing DSM-IV-TR and DSM-5 criteria. J Clin Psychiatry. [In press].
4.
Hudson JI, Lalonde JK, Coit CE, Tsuang MT, McElroy SL, Crow SJ, et al. Longitudinal study of the diagnosis of components of the metabolic syndrome in individuals with binge-eating disorder. Am J Clini Nutr. 2010;91(6):1568–73.CrossRef
5.
Castellini G, Lo Sauro C, Mannucci E, Ravaldi C, Rotella CM, Faravelli C, et al. Diagnostic crossover and outcome predictors in eating disorders according to DSM-IV and DSM-V proposed criteria: a 6-year follow-up study. Psychosom Med. 2011;73(3):270–9.CrossRefPubMed
6.
Fichter MM, Quadflieg N. Long-term stability of eating disorder diagnoses. Int J Eat Disord. 2007;40:S61–6.CrossRefPubMed
7.
Fichter MM, Quadflieg N, Hedlund S. Long-term course of binge eating disorder and bulimia nervosa: relevance for nosology and diagnostic criteria. Int J Eat Disord. 2008;41(7):577–86.CrossRefPubMed
8.
Stice E, Marti CN, Rohde P. Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective community study of young women. J Abnorm Psychol. 2013;122(2):445–57.CrossRefPubMedPubMedCentral
9.
Eddy KT, Dorer DJ, Franko DL, Tahilani K, Thompson-Brenner H, Herzog DB. Diagnostic crossover in anorexia nervosa and bulimia nervosa: implications for DSM-V. Am J Psychiatry. 2008;165(2):245–50.CrossRefPubMedPubMedCentral
10.
11.
Tozzi F, Thornton L, Klump K, Bulik C, Fichter M, Halmi K, et al. Symptom fluctuation in eating disorders: correlates of diagnostic crossover. Am J Psychiatry. 2005;162:732–40.CrossRefPubMed
12.
Becker DF, Grilo CM. Comorbidity of mood and substance use disorders in patients with binge-eating disorder: Associations with personality disorder and eating disorder pathology. J Psychosom Res. 2015;79(2):159–64.CrossRefPubMed
13.
Fontenelle LF, Vltor Mendlowicz M, de Menezes GB, Papelbaum M, Freitas SR, Godoy-Matos A, et al. Psychiatric comorbidity in a Brazilian sample of patients with binge-eating disorder. Psychiatry Res. 2003;119(1-2):189–94.CrossRefPubMed
14.
Grilo C, White M, Barnes R, Masheb R. Psychiatric disorder co-morbidity and correlates in an ethnically diverse sample of obese patients with binge eating disorder in primary care settings. Comp Psychiatry. 2013;54:209–16.CrossRef
15.
Grucza RA, Przybeck TR, Cloninger CR. Prevalence and correlates of binge eating disorder in a community sample. Comp Psychiatry. 2007;48(2):124–31.CrossRef
16.
Hudson JI, Hiripi E, Pope Jr HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007;61(3):348–58.CrossRefPubMedPubMedCentral
17.
Javaras KN, Pope HG, Lalonde JK, Roberts JL, Nillni YI, Laird NM, et al. Co-occurrence of binge eating disorder with psychiatric and medical disorders. J Clin Psychiatry. 2008;69(2):266–73.CrossRefPubMed
18.
Johnson JG, Spitzer RL, Williams JB. Health problems, impairment and illnesses associated with bulimia nervosa and binge eating disorder among primary care and obstetric gynaecology patients. Psychol Med. 2001;31(8):1455–66.CrossRefPubMed
19.
Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents. Results from the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry. 2011;68(7):714–23.CrossRefPubMed
20.
Wilfley DE, Friedman MA, Dounchis JZ, Stein RI, Welch RR, Ball SA. Comorbid psychopathology in binge eating disorder: relation to eating disorder severity at baseline and following treatment. J Consult Clin Psychol. 2000;68(4):641–9.CrossRefPubMed
21.
Swedish Association of Local Authorities and Regions. National Healthcare Quality Registries in Sweden. Stockholm: Edita; 2007.
22.
Birgegård A, Björck C, Clinton D. Quality assurance of specialised treatment of eating disorders using large-scale Internet-based collection systems: methods, results and lessons learned from designing the Stepwise database. Eur Eat Disord Rev. 2010;18(4):251–9.CrossRefPubMed
23.
24.
25.
26.
27.
D’Onofrio BM, Class QA, Rickert ME, Larsson H, Langstrom N, Lichtenstein P. Preterm birth and mortality and morbidity: a population-based quasi-experimental study. JAMA Psychiatry. 2013;70(11):1231–40.CrossRefPubMed
28.
Runfola CD, Thornton LM, Pisetsky EM, Bulik CM, Birgegard A. Self-image and suicide in a Swedish national eating disorders clinical register. Comp Psychiatry. 2014;55(3):439–49.CrossRef
29.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourthth ed. Washington, DC: American Psychiatric Press; 2000.
30.
SAS Institute Inc. Base SAS® 9.4 Procedures Guide: Statistical Procedures. Cary, NC: SAS Institute Inc.; 2013.
31.
Mather AA, Cox BJ, Enns MW, Sareen J. Associations of obesity with psychiatric disorders and suicidal behaviors in a nationally representative sample. J Psychosom Res. 2009;66(4):277–85.CrossRefPubMed
32.
Striegel RH, Bedrosian R, Wang C, Schwartz S. Why men should be included in research on binge eating: results from a comparison of psychosocial impairment in men and women. Int J Eat Disord. 2012;45(2):233–40.CrossRefPubMed
33.
Brownley KA, Berkman ND, Peat CM, Lohr KN, Cullen KE, Bann KE, Bulik CM. Binge-eating disorder in adults: A systematic review and meta-analysis. Ann Intern Med. (in press).
34.
Pisetsky EM, Thornton LM, Lichtenstein P, Pedersen NL, Bulik CM. Suicide attempts in women with eating disorders. J Abnorm Psychol. 2013;122(4):1042–56.CrossRefPubMed
35.
Ljung T, Chen Q, Lichtenstein P, Larsson H. Common etiological factors of attention-deficit/hyperactivity disorder and suicidal behavior: a population-based study in Sweden. JAMA Psychiatry. 2014;71(8):958–64.CrossRefPubMed
36.
Hege MA, Stingl KT, Kullmann S, Schag K, Giel KE, Zipfel S, et al. Attentional impulsivity in binge eating disorder modulates response inhibition performance and frontal brain networks. Int J Obes (Lond). 2015;39(2):353–60.CrossRef
37.
Schag K, Schonleber J, Teufel M, Zipfel S, Giel KE. Food-related impulsivity in obesity and binge eating disorder--a systematic review. Obes Rev. 2013;14(6):477–95.CrossRefPubMed
38.
Anestis MD, Soberay KA, Gutierrez PM, Hernandez TD, Joiner TE. Reconsidering the link between impulsivity and suicidal behavior. Pers Soc Psychol Rev. 2014;18(4):366–86.CrossRefPubMed
39.
McGirr A, Renaud J, Bureau A, Seguin M, Lesage A, Turecki G. Impulsive-aggressive behaviours and completed suicide across the life cycle: a predisposition for younger age of suicide. Psychol Med. 2008;38(3):407–17.CrossRefPubMed
40.
Rimkeviciene J, O’Gorman J, De Leo D. Impulsive suicide attempts: a systematic literature review of definitions, characteristics and risk factors. J Affect Disord. 2015;171:93–104.CrossRefPubMed
41.
Copeland WE, Bulik CM, Zucker N, Wolke D, Lereya ST, Costello EJ. Does childhood bullying predict eating disorder symptoms? A prospective, longitudinal analysis. Int J Eat Disord. 2015;48(8):1141–9.CrossRefPubMed
42.
Bruffaerts R, Demyttenaere K, Borges G, Haro JM, Chiu WT, Hwang I, et al. Childhood adversities as risk factors for onset and persistence of suicidal behaviour. Br J Psychiatry. 2010;197(1):20–7.CrossRefPubMedPubMedCentral
43.
Johnson JG, Cohen P, Gould MS, Kasen S, Brown J, Brook JS. Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Arch Gen Psychiatry. 2002;59(8):741–9.CrossRefPubMed
Metadata
Title
Treatment-seeking patients with binge-eating disorder in the Swedish national registers: clinical course and psychiatric comorbidity
Authors
Elisabeth Welch
Andreas Jangmo
Laura M. Thornton
Claes Norring
Yvonne von Hausswolff-Juhlin
Barry K. Herman
Manjiri Pawaskar
Henrik Larsson
Cynthia M. Bulik
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-0840-7

Other articles of this Issue 1/2016

BMC Psychiatry 1/2016 Go to the issue

Research article

The psychosocial problems of families caring for relatives with mental illnesses and their coping strategies: a qualitative urban based study in Dar es Salaam, Tanzania

Research article

Altered intrinsic insular activity predicts symptom severity in unmedicated obsessive-compulsive disorder patients: a resting state functional magnetic resonance imaging study

Research article

Quantifying the impact of chronic conditions on a diagnosis of major depressive disorder in adults: a cohort study using linked electronic medical records

Research article

Validation of the clutter image rating (CIR) scale among psychiatric outpatients in Singapore

Research article

Pathway to mental health recovery: a qualitative and quantitative study on the needs of Chinese psychiatric inpatients

Study protocol

Psychotherapy integration under scrutiny: investigating the impact of integrating emotion-focused components into a CBT-based approach: a study protocol of a randomized controlled trial