Prevalence of personality disorders in adults with binge eating disorder—A systematic review and Bayesian meta‐analysis

Abstract

SummaryBinge eating disorder (BED) is a complex mental health problem entailing high risk for obesity, overweight, and other psychiatric disorders. However, there is still unclear evidence of the prevalence of personality disorders (PDs) in BED patients. We conducted a systematic review and a Bayesian meta‐analysis for studies examining the prevalence of any PD in adult BED patients. Data sources included PubMed, Cochrane library, EBSCO, PsycINFO, and Science Direct. A Bayesian meta‐analysis was conducted to estimate effect sizes for the prevalence of any PD in BED patients. Twenty eligible articles were examined with a total of 2945 BED patients. Borderline personality disorder and “Cluster C” PD, particularly obsessive‐compulsive and avoidant PD, were the most frequent PD found in BED patients. BED diagnosis was associated with 28% probability of a comorbid diagnosis of any PD (0.279, 95%CrI: [0.22, 0.34]), with high levels of between‐study heterogeneity (τ = 0.61, 95% CrI [0.40, 0.90]). Sensitivity analysis suggested effect sizes ranging from 0.27 to 0.28. The high comorbidity of PDs in BED patients draws attention to the potential complexity of BED clinical presentations, including those that might also be comorbid with obesity. Clinical practice should address this complexity to improve care for BED and obesity patients.

Clinical Factors Associated with Binge-Eating Episodes or Purging Behaviors in Patients Affected by Eating Disorders: A Cross-Sectional Study

“…Given that our sample included a mix of ED diagnoses, it may not have been sufficiently representative of each individual diagnosis to detect self-harm behaviors. Moreover, borderline PD was found to be more represented in binge-eating patients in our sample, consistent with previous studies [ 25 , 71 ]. Of note, a comorbidity with a PD in patients suffering from BN represents a risk factor for increased all-cause mortality [ 72 ].…”

“…Moreover, common clinical and psychopathological features, such as external cue reactivity, craving, emotion dysregulation, and impulsivity, along with alterations of the dopaminergic system, may favor chronicity in binge eating [ 61 , 66 ]. Nevertheless, the exact nature of the association between BED and PDs remains to be clarified [ 71 ].…”