Revista Colombiana de Psiquiatría
Print version ISSN 0034-7450
RODRIGUEZ GUARIN, Maritza. Drug Use, Impulsivity, and Trauma in Patients with Eating Disorders: a Triad of Risks for Complex Comorbidities affecting the Prognosis. rev.colomb.psiquiatr. [online]. 2009, vol.38, n.3, pp. 420-432. ISSN 0034-7450.
Introduction: Few studies have explored, in a clinical population of patients receiving outpatient treatment for eating disorders (ED), the variables drug abuse and dependency, history of trauma, and multi-impulsivity, and their impact on treatment compliance and prognosis. The objective of this study is to do so and analyze their impact on relapse frequency and early treatment dropout. Method: 578 male and female patients, who consecutively entered the outpatient program EQUILIBRIO in Bogotá between June 1997 and December 2007 to be treated for their eating disorders, were studied using the DSM-IV Structured Clinical Interview (SCID 1). Results: On entry, 201 patients presented with nervous anorexia; 220 with nervous bulimia; 121 with food gorging disorder; and 36 with incomplete pictures of anorexia or bulimia; 108 had drug-related problems (alcohol, marijuana, cocaine and other stimulants) at the time of entry to the program. Of the main group 111 periodically self-injured. Conclusion: The presence of drug abuse and trauma history is associated with a complex pattern of predominantly impulsive comorbidities, with a higher risk for suicide attempts, other parasuicidal behaviours, relapses or early treatment dropout. This situation makes it necessary to manage each comorbidity specifically.
Keywords : Eating disorders; drug-related disorders; comorbidity; prognosis.