Borderline diagnosis and substance abuse in female patients with eating disorders

To investigate whether alcohol and drug abuse are symptomatic of eating disorders or related to a concomitant borderline personality disorder, we reviewed all female inpatient medical records filed at the Department of Psychosomatic Medicine between 1978 and 1990. Over 300 records were assessable. The patients were reclassified according to DSM-III-R with regard to eating and borderline personality disorders. Alcohol and drug abuse were also taken into account. Nearly 5% of patients had a borderline personality disorder. Nearly 25% of patients suffered from eating disorders, and 11% of them had a concomitant borderline personality disorder. A detailed examination showed the frequency of abuse of alcohol and tranquilizers to be no higher, but that of laxatives and/or diuretics and/or anorexigenics to be significantly higher in borderline patients with concurrent eating disorder. However, the incidence of alcohol abuse was significant in borderline patients.