Psychiatric disorder co-morbidity and correlates in an ethnically diverse sample of obese patients with binge eating disorder in primary care settings

ObjectiveTo examine DSM-IV lifetime/current psychiatric disorder co-morbidity and correlates in ethnically-diverse obese patients with binge eating disorder (BED) seeking treatment for obesity and binge eating in primary care.MethodA consecutive series of 142 participants (43% Caucasian, 37% African–American, 13% Hispanic–American, and 7% “other” ethnicity) were evaluated with semi-structured interviews.Results67% of BED patients had at least one additional lifetime psychiatric disorder, with mood (49%), anxiety (41%), and substance-use (22%) disorders most common. In terms of current co-morbidity, 37% had at least one other psychiatric disorder, with anxiety (27%) and mood (17%) most common. Few gender differences were observed but psychiatric co-morbidity rates differed across ethnic/racial groups with larger differences for current diagnoses. African–American and Hispanic groups were more than twice as likely as the Caucasian group to have additional current psychiatric disorders, mood disorders, and anxiety disorders. Psychiatric co-morbidity was associated with greater eating-disorder psychopathology and poorer functioning, but not with binge-eating or BMI.ConclusionOur study presents new findings suggesting that among obese BED patients in primary care, ethnic/racial minority groups are more likely than Caucasian groups to present with psychiatric co-morbidity. Within BED, psychiatric co-morbidity shows few gender differences but is associated with greater eating-disorder psychopathology and poorer functioning.