Eating disorders and subsequent risk of substance use disorders involving illicit drugs: a Danish nationwide register-based cohort study

Lotte Skøt*, Anna Mejldal, Maria Mercedes Guala, René Klinkby Støving, Leonie Ascone, Elsebeth Stenager, Mia Beck Lichtenstein, Angelina Isabella Mellentin

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Purpose: No study has investigated the ongoing risk of substance use disorders involving illicit drugs (ISUD) after first eating disorder (ED) and whether the pattern of risk differs according to types of ED and ISUD. Therefore, we aimed to longitudinally assess the risk of a subsequent diagnosis of any ISUD (pooled category) and specific ISUD after a first-time diagnosis of anorexia nervosa (AN), bulimia nervosa (BN), or unspecified ED (USED). Methods: A retrospective cohort study using data from Danish nationwide registers identified 20,759 ED patients and 83,038 matched controls (1:4 ratio). Risk of any ISUD diagnosis after first ED diagnosis was estimated by generating hazard ratios (HR). Logistic regression was applied to assess associations between each ED and specific ISUD. Results: Patients with AN, BN, and USED (without a prior ISUD diagnosis) exhibited an increased relative risk of a subsequent diagnosis of any ISUD compared with respective controls, and the elevated risk persisted over 10 years (AN, adjusted HRs ranging from 1.60 [99% CI 1.15–2.24] to 5.16 [3.14–8.47]; BN, 2.35 [1.46–3.79] to 14.24 [6.88–29.47]; USED, 2.86 [1.35–3.79] to 8.56 [3.31–29.47]). The highest estimates were observed during the first year of follow-up. Each ED type was associated with an increased likelihood of all types of ISUD. AN and USED were most strongly associated with sedatives/hypnotics, BN with other illegal substances (e.g., ecstasy and hallucinogens). Conclusions: ED patients have a considerable risk for subsequent ISUD. Prevention efforts and treatment targeting ISUD are likely required to improve ED treatment prognosis.

Original languageEnglish
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume57
Pages (from-to)695-708
ISSN0933-7954
DOIs
Publication statusPublished - Apr 2022

Bibliographical note

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

Keywords

  • Anorexia nervosa
  • Bulimia nervosa
  • Comorbidity
  • Illicit substances
  • Substance use disorders
  • Unspecified eating disorder
  • Humans
  • Bulimia Nervosa/epidemiology
  • Substance-Related Disorders/epidemiology
  • Denmark/epidemiology
  • Anorexia Nervosa
  • Illicit Drugs/adverse effects
  • Feeding and Eating Disorders/epidemiology
  • Retrospective Studies
  • Cohort Studies

Fingerprint

Dive into the research topics of 'Eating disorders and subsequent risk of substance use disorders involving illicit drugs: a Danish nationwide register-based cohort study'. Together they form a unique fingerprint.

Cite this