Comorbidity between PTSD and EDs: Occurrence, Mutual Facilitation, and Integrated Treatment

This paper reviews literature related to comorbid post-traumatic stress disorder (PTSD) and eating disorders(ED). Meta-analysis estimates that about 1 in 5 people who present with PTSD are also diagnosed with a comorbid eating disorder, and about 1 in 4 people who present with an eating disorder are diagnosed with comorbid PTSD. However, despite the widespread occurrence, an integrated evidence-based treatment has yet to be established. Preliminary research proposes multiple theories for comorbidity rates. Some propose stress-induced glutaminergic dysfunction may facilitate both disorders, while others contend disordered eating behaviors are maladaptive coping mechanisms for negative affect. Regardless of the underlying mechanism, people with PTSD-ED face additional challenges in the recovery process, including increased symptom severity, greater non-completion rates, and frequent relapse. Considering these challenges, studies on integrated therapies using Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and Family Therapy have begun. Integrated CBT for ED-PTSD has demonstrated preliminary success in reducing symptoms of both disorders. While PTSD and eating disorders have been extensively studied independently, there is a lack of literature on comorbid PTSD-ED. The current review hopes to bring awareness of shared development, challenges, and treatment response to encourage further integrated studyFor correspondence, please contact the researcher at ajavolio@live.carlow.edu