Eating Disorder Center for Treatment and Research, Department of Psychiatry, University of California, San Diego, CA, USA.
Mount Sinai Department of Psychiatry, Icahn School of Medicine.
Eat Disord. 2020 Mar-Apr;28(2):142-156. doi: 10.1080/10640266.2020.1740913. Epub 2020 Apr 17.
Given the high rates of comorbidity between eating disorders (EDs) and substance use disorders (SUDs), it is important to develop effective treatment approaches for individuals with both an ED and SUD (ED-SUD). To date, there is limited information guiding the concurrent treatment of these disorders. To build on existing research, the present study compared adult patients with ED-SUD ( = 36) to patients with ED-only ( = 62) in terms of demographics, psychiatric comorbidity, and self-reported eating disorder and related psychopathology. Results indicated that ED-SUD patients had a higher number of psychiatric comorbidities, were more likely to be prescribed mood stabilizers, and were more sensitive to reward. They also reported greater difficulty with emotion regulation, including more difficulty engaging in goal-directed activity, higher impulsivity, and more limited access to emotion regulation strategies. These differences highlight the importance of targeting emotion dysregulation for ED-SUD, and provide evidence for the importance of integrated, transdiagnostic treatment to simultaneously address the SUD, ED, and other psychiatric comorbidities. Implications for tailoring treatment are discussed with a focus on Dialectical Behavior Therapy (DBT).
鉴于饮食障碍（EDs）和物质使用障碍（SUDs）之间的高共病率，为同时患有 ED 和 SUD（ED-SUD）的个体开发有效的治疗方法非常重要。迄今为止，关于这些疾病的同时治疗的信息有限。为了利用现有研究，本研究比较了 ED-SUD 患者（n=36）和仅 ED 患者（n=62）在人口统计学、精神共病和自我报告的饮食障碍及相关心理病理学方面的差异。结果表明，ED-SUD 患者的精神共病更多，更有可能被开情绪稳定剂，并且对奖励更敏感。他们还报告说情绪调节更困难，包括更难进行目标导向的活动、更高的冲动性和更有限的情绪调节策略。这些差异突出了针对 ED-SUD 的情绪失调的重要性，并为同时解决 SUD、ED 和其他精神共病的综合、跨诊断治疗提供了证据。讨论了针对治疗的影响，重点是辩证行为疗法（DBT）。
