First-degree relative history of alcoholism in eating disorder inpatients: Relationship to eating and substance use psychopathology

Objective: We examined the influence of family history of alcoholism on the presentation and course of inpatients with eating disorders (ED) by comparing ED behaviors, substance abuse behaviors, and psychopathology of patients with alcoholic first-degree relatives (AFDR+) to those without alcoholic first-degree relatives (AFDR-). Method: Female inpatients admitted to a specialty eating disorders service completed demographic, family history, behavioral, and psychological questionnaires (N = 217). Body mass index (BMI) at admission and discharge, length of stay, and rates of weight gain were calculated. Results: AFDR+ participants did not differ from AFDR- participants diagnostically, but AFDR+ participants did report higher lifetime frequencies of several ED and substance abuse behaviors. Measures of ED psychopathology and personality vulnerability were also elevated in the AFDR+ group. Discussion: ED inpatients with a first-degree family history of alcoholism demonstrate increased psychopathology in eating behavior, substance use, and personality vulnerability domains. While the genetic diathesis for alcoholism is likely distinct from that for eating disorders, these findings suggest that first-degree relative history of alcoholism may nevertheless exert a negative influence on eating disorder behaviors.