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A comparative analysis of role attainment and impairment in binge-eating disorder and bulimia nervosa: results from the WHO World Mental Health Surveys

Part of: Special Articles

Published online by Cambridge University Press:  19 September 2013

R.C. Kessler ,
V. Shahly ,
J.I. Hudson ,
D. Supina ,
P.A. Berglund ,
W.T. Chiu ,
M. Gruber ,
S. Aguilar-Gaxiola ,
J. Alonso  and
L.H. Andrade
...Show all authors
R.C. Kessler*
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
V. Shahly
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
J.I. Hudson
Affiliation:
Psychiatric Epidemiology Research Program, McLean Hospital and Harvard Medical School, Boston, Massachusetts, USA
D. Supina
Affiliation:
Health Economics, Outcomes Research and Epidemiology, Shire Pharmaceuticals, Wayne, Pennsylvania
P.A. Berglund
Affiliation:
University of Michigan, Institute for Social Research, Ann Arbor, Michigan, USA
W.T. Chiu
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
M. Gruber
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
S. Aguilar-Gaxiola
Affiliation:
University of California, Davis, Center for Reducing Health Disparities, School of Medicine, CTSC Building, Sacramento, California, USA
J. Alonso
Affiliation:
IMIM-Hospital del Mar Research Institute, Parc de Salut Mar; Pompeu Fabra University (UPF); and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
L.H. Andrade
Affiliation:
Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
C. Benjet
Affiliation:
Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
R. Bruffaerts
Affiliation:
Universitair Psychiatrisch Centrum – Katholieke Universiteit Leuven (UPC-KUL), campus Gasthuisberg, Leuven, Belgium
G. de Girolamo
Affiliation:
IRCCS Centro S. Giovanni di Dio Fatebenefratelli Brescia, Bologna, Italy
R. de Graaf
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
S.E. Florescu
Affiliation:
National School of Public Health, Management and Professional Development, Bucharest, Romania
J.M. Haro
Affiliation:
Parc Sanitari Sant Joan de Déu, CIBERSAM, University of Barcelona, Barcelona, Spain
S.D. Murphy
Affiliation:
School of Psychology, University of Ulster, Londonderry, Northern Ireland
J. Posada-Villa
Affiliation:
Universidad Colegio Mayor de Cundinamarca, Bogota, Colombia
K. Scott
Affiliation:
Department of Psychological Medicine, Otago University, Dunedin, New Zealand
M. Xavier
Affiliation:
Department of Mental Health – CEDOC and Faculdade Ciencias Medicas, Universidade Nova de Lisboa, Lisbon, Portugal
*
*Address for correspondence: R.C. Kessler, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, USA. (Email: [email protected])
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Abstract

Background.

Cross-national population data from the WHO World Mental Health surveys are used to compare role attainments and role impairments associated with binge-eating disorder (BED) and bulimia nervosa (BN).

Methods.

Community surveys assessed 23 000 adults across 12 countries for BED, BN and ten other DSM-IV mental disorders using the WHO Composite International Diagnostic Interview. Age-of-onset was assessed retrospectively. Ten physical disorders were assessed using standard conditions checklists. Analyses examined reciprocal time-lagged associations of eating disorders (EDs) with education, associations of early-onset (i.e., prior to completing education) EDs with subsequent adult role attainments and cross-sectional associations of current EDs with days of role impairment.

Results.

BED and BN predicted significantly increased education (females). Student status predicted increased risk of subsequent BED and BN (females). Early-onset BED predicted reduced odds of current (at time of interview) marriage (females) and reduced odds of current employment (males). Early-onset BN predicted increased odds of current work disability (females and males). Current BED and BN were both associated with significantly increased days of role impairment (females and males). Significant BED and BN effects on adult role attainments and impairments were explained by controls for comorbid disorders.

Conclusions.

Effects of BED on role attainments and impairments are comparable with those of BN. The most plausible interpretation of the fact that these associations are explained by comorbid disorders is that causal effects of EDs are mediated through secondary disorders. Controlled treatment effectiveness studies are needed to trace out long-term effects of BED–BN on secondary disorders.

Keywords

Binge eatingbulimia nervosaeating disorderWHO World Mental Health Surveys
Type
Special Article
Information
Epidemiology and Psychiatric Sciences , Volume 23 , Issue 1 , March 2014 , pp. 27 - 41
Copyright
Copyright © Cambridge University Press 2013 

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