Prevalence and correlates of DSM-5 eating disorders in patients with bipolar disorder

Susan L. McElroy*, Scott Crow, Thomas J. Blom, Joanna M. Biernacka, Stacey J. Winham, Jennifer Geske, Alfredo B. Cuellar-Barboza, William V. Bobo, Miguel L. Prieto, Marin Veldic, Nicole Mori, Lisa R. Seymour, David J. Bond, Mark A. Frye

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

62 Scopus citations


Objective To determine prevalence rates and clinical correlates of current DSM-5 eating disorders in patients with bipolar disorder (BP). Methods Prevalence rates of current DSM-5- and DSM-IV-defined binge eating disorder (BED), bulimia nervosa (BN), and anorexia nervosa (AN) were assessed with the Eating Disorder Diagnostic Scale (EDDS) in 1092 patients with BP. Psychiatric illness burden was evaluated with five proxy measures of BP illness severity. Medical illness burden was evaluated with the Cumulative Index Rating Scale (CIRS). Results Twenty-seven percent of patients had a current DSM-5 eating disorder: 12% had BED, 15% had BN, and 0.2% had AN. Rates of DSM-5-defined BED and BN were higher than clinical diagnosis rates and rates of DSM-IV-defined BED and BN. Compared with BP patients without an eating disorder, BP patients with a DSM-5 eating disorder were younger and more likely to be women; had an earlier age of onset of BP; had higher EDDS composite scores and higher degrees of suicidality, mood instability, and anxiety disorder comorbidity; and had a higher mean BMI, higher rate of obesity, and higher CIRS total scores. In a logistic regression model controlling for previously identified correlates of an eating disorder, younger age, female gender, and higher BMI remained significantly associated with an eating disorder. Limitations The EDDS has not been validated in BP patients. Conclusion DSM-5-defined BED and BN are common in BP patients, possibly more common than DSM-IV-defined BED and BN, and associated with greater psychiatric and general medical illness burden. Further studies assessing DSM-5 eating disorders in people with BP are greatly needed.

Original languageEnglish
Pages (from-to)216-221
Number of pages6
JournalJournal of Affective Disorders
StatePublished - 1 Feb 2016

Bibliographical note

Funding Information:
Funding for the study was provided by the Marriott Foundation . The foundation had no further role in the study design, analysis or interpretation of the data, writing of the report, or decision to submit the paper for publication.

Publisher Copyright:
© 2015 Elsevier B.V. All rights reserved.


  • Binge eating
  • Bipolar disorder
  • Bulimia nervosa
  • DSM-5 eating disorders


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