Prevalence and Factors Related to Substance Use among Adolescents with Eating Disorders

Castro‐Fornieles, Josefina; Díaz, Rosa; Goti, Javier; Calvo, Rosa; Gonzalez, Laura; Serrano, Lourdes; Gual, Antoni

doi:10.1159/000268106

Cited by 26 publications

(29 citation statements)

References 75 publications

(57 reference statements)

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“…delinquent behavior, aggression, inattention). 12 These findings reflect a similar trend found in the adult literature.…”

Section: Introductionsupporting

confidence: 90%

“…patient describes “trying” or “experimenting” once or twice), or regularly used (frequencies included monthly, daily, or repeated binge use). A similar grouping for risky use in teens has been used in previous studies, 12,27,28 and regular use by this categorization has been found to indicate increased risk of developing mood symptoms and disruptive behavior disorders. 27 …”

Section: Methodsmentioning

confidence: 58%

“…10 Across adolescent AN and BN patients, binge-purge behavior was associated with risky tobacco, alcohol, and other substance use, compared to those with restrictive eating patterns. 12 Similarly, girls with bulimic symptoms (i.e. binge eating/purging behavior) had higher rates of substance use than those with primarily restrictive patterns.…”

Section: Introductionmentioning

confidence: 97%

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Factors Associated With Substance Use in Adolescents With Eating Disorders

Mann

Accurso

Stiles‐Shields

et al. 2014

Journal of Adolescent Health

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Purpose To examine the prevalence and potential risk factors associated with substance use in adolescents with eating disorders (EDs). Methods This cross-sectional study included 290 adolescents, ages 12 –18 years, who presented for an initial ED evaluation at The Eating Disorders Program at The University of Chicago Medicine (UCM) between 2001 and 2012. Several factors, including DSM-5 diagnosis, diagnostic scores, and demographic characteristics were examined. Multinomial logistic regression was used to test associations between several factors and patterns of drug use for alcohol, cannabis, tobacco, and any substance. Results Lifetime prevalence of any substance use was found to be 24.6% in those with anorexia nervosa (AN), 48.7% in bulimia nervosa (BN), and 28.6% in eating disorder not otherwise specified (EDNOS). Regular substance use (monthly, daily, and bingeing behaviors) or a substance use disorder (SUD) was found in 27.9% of all patients. Older age was the only factor associated with regular use of any substance in the final multinomial model. Older age and non-White race was associated with greater alcohol and cannabis use. Although binge-purge frequency and BN diagnosis were associated with regular substance use in bivariate analyses, gender, race and age were more robustly associated with substance use in the final multinomial models. Conclusions Co-morbid substance use in adolescents with EDs is an important issue. Interventions targeting high-risk groups reporting regular substance use or SUDs are needed.

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“…delinquent behavior, aggression, inattention). 12 These findings reflect a similar trend found in the adult literature.…”

Section: Introductionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

Factors Associated With Substance Use in Adolescents With Eating Disorders

Mann

Accurso

Stiles‐Shields

et al. 2014

Journal of Adolescent Health

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“…For example, Stock et al (2002) reported that female adolescents with an ED with purging symptoms used substances in order to relax/improve mood, manage anger, avoid problems and control eating [69]. The high rates of concurrent EDs and SUDs found in adolescents reflect these developmental challenges and highlight the importance of accurate assessment and intervention for this population [9,24,61,70]. …”

Section: Reviewmentioning

confidence: 99%

A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders

2013

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IntroductionResearch has shown that eating disorder (ED) patients who abuse substances demonstrate worse ED symptomatology and poorer outcomes than those with EDs alone, including increased general medical complications and psychopathology, longer recovery times, poorer functional outcomes and higher relapse rates. This article provides a broad overview of the prevalence, aetiology, assessment and management of co-morbid EDs and substance use disorders (SUDs).ReviewThe co-occurrence of EDs and SUDs is high. The functional relationship between EDs and SUDs vary within and across ED subtypes, depends on the class of substance, and needs to be carefully assessed for each patient. Substances such as caffeine, tobacco, insulin, thyroid medications, stimulants or over the counter medications (laxatives, diuretics) may be used to aid weight loss and/or provide energy, and alcohol or psychoactive substances could be used for emotional regulation or as part of a pattern of impulsive behaviour. A key message conveyed in the current literature is the importance of screening and assessment for co-morbid SUDs and EDs in patients presenting with either disorder. There is a paucity of treatment studies on the management of co-occurring EDs and SUDs. Overall, the literature indicates that the ED and SUD should be addressed simultaneously using a multi-disciplinary approach. The need for medical stabilization, hospitalization or inpatient treatment needs to be assessed based on general medical and psychiatric considerations. Common features across therapeutic interventions include psycho-education about the aetiological commonalities, risks and sequelae of concurrent ED behaviours and substance abuse, dietary education and planning, cognitive challenging of eating disordered attitudes and beliefs, building of skills and coping mechanisms, addressing obstacles to improvement and the prevention of relapse. Emphasis should be placed on building a collaborative therapeutic relationship and avoiding power struggles. Cognitive behavioural therapy has been frequently used in the treatment of co-morbid EDs and SUDs, however there are no randomized controlled trials. More recently evidence has been found for the efficacy of dialectical behavioural therapy in reducing both ED and substance use behaviours.ConclusionFuture research would benefit from a meta-analysis of the current research in order to better understand the relationships between these two commonly co-occurring disorders.

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“…Como señalan Castro-Fornieles et al (2010), los problemas del abuso de sustancias en adolescentes con TCA se correlacionan con mayor número de problemas escolares, sociales y familiares que los que padeciendo un TCA no presentan consumo de sustancias, por lo que sería conveniente que se detectasen y se pudiera dar un enfoque terapéutico específico adecuán-dolo a estas personas. Para ello sería necesario distinguir entre los subgrupos de TCA y los diferentes tipos de sustancias, sin embargo son escasos los estudios que detallan el tipo de sustancia de uso o abuso que suele utilizar la población adolescente que cumple o que está en riesgo de cumplir alguno de los criterios diagnósticos del DSM-IV-TR para los TCA, y de los que existen, han mostrado una relación directa entre las dietas y los atracones (con o sin conductas purgativas) con el uso o abuso de drogas estimulantes, entre las que se encuentra el tabaco (Piran y Robinson, 2006; Stice y Shaw, 2003).…”

Section: Introductionunclassified

Consumo de tabaco en población escolarizada y su relación con los trastornos de la conducta alimentaria

Barea

Zamudio

2017

PSYWRIT

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ResumenHay estudios que avalan una relación significativa entre el riesgo de padecer un Trastorno de la Conducta Alimentaria (TCA) y el consumo de tabaco como medida de control del apetito. El objetivo de este estudio es analizar la asociación entre el consumo de tabaco y actitudes y comportamientos presentes en la anorexia y bulimia nerviosas. El diseño del estudio es observacional analítico de casos y controles. La muestra estuvo constituida por 300 participantes de ambos sexos, de entre 12 y 20 años de edad, que respondieron a los siguientes instrumentos de evaluación: EAT-26, EDI-II, BULIT-R y un cuestionario adaptado sobre comportamientos, actitudes y opiniones hacia el tabaco. Se categorizaron las variables cuantitativas continuas y se agruparon a los participantes en grupos sintomáticos y asintomáticos. En el grupo sintomático, se constató que en la variable "haber fumado diariamente, al menos un cigarrillo, durante seis o más meses en la vida" se obtuvo una diferencia estadísti-camente significativa χ² (1, N = 300) = 7.536, p< .01, y de magnitud baja (V = .159), en el EAT-26. Para el BULIT-R en esta misma variable se alcanzó una diferencia estadís-ticamente significativa χ²(1, N = 300) = 8.740, p< .01, y de magnitud baja (V= .171). Para la variable "consumo diario actual de cigarrillos" se alcanzó una diferencia estadística-mente significativa χ² (2, N = 300) = 15.561, p< .01, y de magnitud baja (V = .228), en el EAT-26. Para el BULIT-R en esta misma variable se obtuvo una diferencia estadís-ticamente significativa χ² (2, N = 300) = 6.237, p< .05, y de magnitud baja (V = .144). Los resultados constatan la relación existente entre el consumo de tabaco y grupos sintomáticos afines a los TCA.Palabras clave: consumo de tabaco, adolescente, anorexia nerviosa, bulimia nerviosa, trastornos de la conducta alimentaria. Escritos de Psicología Psychological WritingsAbstract Recent studies have found a significant association between the risk of developing an eating disorder and tobacco consumption as an appetite suppressant. The aim of this study was to determine the association between tobacco consumption and attitudes and behaviours associated with eating disorders. The study design was an analytical observational case-control study. The study included 300 participants of both genders participated (age range, 12--20 years). The following assessment questionnaires were used: EAT-26, EDI-II, BULIT-R, and an adapted questionnaire on behaviour, attitude, and opinions regarding tobacco. Continuous variables were categorized. Participants were grouped as symptomatic and asymptomatic. In the symptomatic group, there was a statistically significant difference between the variable "having smoked at least one cigarette daily for 6 or more months lifetime" and EAT-26 (χ² = 7.536, 1 df, Cramer's V = 0.159, p< 0.01) and BULIT-R (χ² = 8.740, 1 df, Cramer´s V = 0.171, p< 0.01) scores. Similarly, there was a significant difference between the variable "current daily cigarette consumption" and the EAT-26 (χ² = 15.565, 2 df, Cram...

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Prevalence and Factors Related to Substance Use among Adolescents with Eating Disorders

Cited by 26 publications

References 75 publications

Factors Associated With Substance Use in Adolescents With Eating Disorders

Factors Associated With Substance Use in Adolescents With Eating Disorders

A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders

Consumo de tabaco en población escolarizada y su relación con los trastornos de la conducta alimentaria

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