DSM-IV psychiatric disorder comorbidity and its correlates in binge eating disorder.

OBJECTIVE: To assess DSM-IV lifetime and current psychiatric disorder comorbidity in patients with binge eating disorder (BED) and to examine associations of comorbidity with gender, selected historical obesity-related variables, and current eating disorder psychopathology.

METHOD: A consecutive series of 404 patients with BED (310 women, 94 men) were reliably administered semistructured diagnostic and clinical interviews to assess DSM-IV psychiatric disorders and features of eating disorders.

RESULTS: Overall, 73.8% of patients with BED had at least one additional lifetime psychiatric disorder and 43.1% had at least one current psychiatric disorder. Lifetime-wise, mood (54.2%), anxiety (37.1%), and substance use (24.8%) disorders were most common. In terms of current comorbidity, mood (26.0%) and anxiety (24.5%) were most common. Few gender differences were observed; men had higher lifetime rates of substance use disorders and current rates of obsessive compulsive disorder. Patients with BED with current psychiatric comorbidity reported earlier age at first diet and higher "lifetime-high" BMI. Patients with current comorbidity also had significantly higher levels of current eating disorder psychopathology and negative affect and lower self-esteem relative to patients with BED with either lifetime (noncurrent) or no psychiatric histories.

DISCUSSION: Among treatment-seeking patients with BED, the presence of current psychiatric comorbidity is associated with greater eating disorder psychopathology and associated distress.