Is there a relationship between bulimia nervosa and hazardous alcohol use?

Objective: The present study investigates the relationship between hazardous alcohol consumption and bulimia nervosa in a clinical population. Method: The Alcohol Use Disorders Identification Test (AUDIT) was administered to two groups of female subjects: patients with bulimia nervosa (n = 30) and nonbulimic controls (n = 15). These two groups were further subdivided on the basis of personality disorder as assessed by the Personality Disorder Examination (PDE), a comprehensive interview covering all of the criteria for the 13 DSM-III-R Axis II disorders. The bulimic patients were referred to a dieting disorders clinic affiliated with the University of Sydney. All met DSM-III-R criteria for bulimia nervosa and all had Body Mass Indices (BMIs) greater than 19. The nonbulimic control group were recruited from an undergraduate psychology course. All subjects were given the Bulimic Investigatory Test, Edinburgh (BITE) and the Eating Disorders Inventory-2 (EDI-2). Results: 66.7% (8/12) of personality disordered bulimic patients were drinking at hazardous levels whereas 61.1% (11/18) of bulimic patients without a personality disorder were doing likewise. Furthermore, 35.7% (5/14) of the nonbulimic controls without personality disorders were drinking at hazardous levels and the only control subject with a personality disorder was doing likewise. The association between personality disorder diagnosis and hazardous alcohol use in the bulimic sample just failed to reach significance at the 5% level (X2 1, upper .05 = 3.84, p = .052). No association between Axis 1 diagnosis of bulimia nervosa and hazardous alcohol use was found (X2 1, upper .05 = 3.84, p = .52). Discussion: The results of the present study suggest we may need to rethink the relationship between hazardous alcohol use and bulimia nervosa reported in the literature, as it may be an artifact of the relationship between personality disorder and hazardous alcohol consumption. Further research is necessary to clarify this issue.