ABSTRACT
Independently, eating disorders and substance use disorders comprise significant psychiatric and general health risks to adolescents. Eating disorders are associated with substantial medical morbidity (Kaplan, 1993; Katzman, 2005; Mitchell, Specker, & De Zwaan, 1991; Reichborn-Kjennerud, Bulik, Sullivan, Tambs, & Harris, 2004). In addition, anorexia nervosa (AN) is commonly comorbid with depression and anxiety disorders (Bulik, Sullivan, Fear, & Joyce, 1997; Halmi et al., 1991; Kaye et al., 2004; Walters & Kendler, 1995) and bulimia nervosa (BN) commonly co-occurs with depression, anxiety disorders, and substance use disorders (Braun, Sunday, & Halmi, 1994; Brewerton et al., 1995; Bulik et al., 2004; Bulik, Sullivan, Fear, & Joyce, 1997; Bulik, Sullivan, Joyce, & Carter, 1997; Bushnell et al., 1994; Fichter & Quadflieg, 1997; Herzog, Keller, Sacks, Yeh, & Lavori, 1992; Perez, Joiner, & Lewinsohn, 2004). Anorexia nervosa has the highest mortality rate of any psychiatric disorder (Birmingham, Su, Hlynsky, Goldner, & Gao, 2005; Sullivan, 1995). AN and BN, combined, constitute the major contribution to excess mortality from psychiatric disorders (Harris & Barraclough, 1998). Likewise, substance use disorders are associated with medical morbidity, suicide attempts and mortality, comorbid psychopathology, and family problems (Bachman, Johnston, O’Malley, & Schulenberg, 1996; Newcomb & Bentler, 1989).
