[Epidemiologic research, disorders of eating behavior and addictive behavior]

The tremendous increase in interest in eating disorders, and especially in bulimia nervosa, that has occurred since the last 1970s has resulted in a large and contradictory literature about the relationships between eating disorders and addictive disorders, especially alcohol and drug abuse. At first sight, according to the differences observed between these disorders in most of their phenomenological characteristics (age, sex, socio-cultural factors), it may seem difficult to draw a parallel between them. However, studies showed that eating behavior problems, alcohol and drug abuse nowadays shared some common features in adolescents and young people. However that may be, epidemiological studies demonstrated a high prevalence of substance abuse among patients with bulimia. In anorexia nervosa, this prevalence seemed to be lower. However, significant differences have been observed between bulimic and restricting anorexics: substance abuse occurred significantly more frequently in bulimic anorexics than in restricting anorexics and this characteristic was associated with a higher prevalence of impulsive behaviors (i.e. stealing, self-mutilation and suicide attempt), laxative or diuretic use and impairments in social relationships. These clinical features are quite similar to those observed in bulimic patients with substance abuse problems. Follow-up studies also showed that substance abuse problems in anorexia nervosa were associated with the occurrence of bulimic behaviors. On the other hand, family studies reported that a high prevalence of patients with bulimia had at least one first degree relatives with substance abuse problems or an affective disorder. In anorexia nervosa, the prevalence of substance abuse or depression among the family members seemed to be higher in bulimic anorexics than in restricting anorexics.(ABSTRACT TRUNCATED AT 250 WORDS)