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Comorbid alcohol and cannabis use disorders increase mortality in patients with eating disorders

Published online by Cambridge University Press:  01 September 2022

L. Stryhn ,
A. Mejldal ,
M. Guala ,
R. Støving ,
E. Stenager ,
L. Skøt  and
A. Mellentin
L. Stryhn*
Affiliation:
Unit for Psychiatric Research, Department of Clinical Research, University Of Southern Denmark, Odense C, Denmark
A. Mejldal
Affiliation:
Unit for Psychiatric Research, Department of Clinical Research, University Of Southern Denmark, Odense C, Denmark
M. Guala
Affiliation:
Unit for Psychiatric Research, Department of Clinical Research, University Of Southern Denmark, Odense C, Denmark Center for Eating Disorders, Odense University Hospital, Odense C, Denmark
R. Støving
Affiliation:
Unit for Psychiatric Research, Department of Clinical Research, University Of Southern Denmark, Odense C, Denmark Center for Eating Disorders, Odense University Hospital, Odense C, Denmark Research Unit for Medical Endocrinology, Institute Of Clinical Research, University Of South Denmark, Odense, Denmark
E. Stenager
Affiliation:
Unit for Psychiatric Research, Institute Of Regional Health Services Research, University Of Southern Denmark, Aabenraa, Denmark
L. Skøt
Affiliation:
Unit for Psychiatric Research, Department of Clinical Research, University Of Southern Denmark, Odense C, Denmark
A. Mellentin
Affiliation:
Unit for Psychiatric Research, Department of Clinical Research, University Of Southern Denmark, Odense C, Denmark Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University Of Southern Denmark, Odense, Denmark
*
*Corresponding author.

Abstract

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Introduction

Alcohol and cannabis use disorders are the most frequent comorbid substance use disorders (SUDs) among patients with eating disorders (EDs). EDs and SUDs involving alcohol and cannabis are independently associated with excess mortality.

Objectives

To investigate the impact of comorbid alcohol use disorder (AUD) and cannabis use disorder (CUD) on mortality in anorexia nervosa (AN), bulimia nervosa (BN), and unspecified eating disorder (USED) compared with matched control subjects.

Methods

This retrospective cohort study was conducted using Danish nationwide registers. The risk of mortality among ED patients with/without AUD and/or CUD was compared to matched control subjects with/without AUD and/or CUD using hazard ratios (HRs).

Results

Of the 20,759 included ED patients, 4.7% and 4.3% had AUD and CUD, respectively. The corresponding figures for the 83,036 control subjects were 1.0% (AUD) and 1.3% (CUD). ED patients without SUDs exhibited an increased risk of mortality compared to control subjects without SUDs (adjusted HR 2.9, P<.001). Mortality risk was higher among ED patients with AUD (adjusted HR 11.8, P<.001) or CUD (adjusted HR 4.6, P<.001) compared to control subjects without AUD/CUD. In addition, patients with AN, BN, and USED, who had comorbid AUD and/or CUD, exhibited an elevated risk of mortality compared to control subjects without AUD/CUD (AN: adjusted HR 11.3, P<.001; BN: adjusted HR 5.9, P<.001; USED: adjusted HR 10.9, P<.001).

Conclusions

Comorbid AUD and/or CUD increase mortality risk in patients with EDs. In order to reduce mortality in ED patients, prevention and treatment of AUD and CUD is important.

Disclosure

No significant relationships.

Keywords

Eating Disorderscannabis use disorderAlcohol use disordermortality
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S125 - S126
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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