Binge Eating Disorder in Bipolar I Disorder: Prevalence, Childhood Trauma, and Clinical Correlates.

Abstract

Introduction: Bipolar I disorder (BD-I) frequently co-occurs with eating disorders, particularly binge eating disorder (BED), which may adversely affect the clinical course, including recurrence risk and functional impairment. Research exploring the specific association between BED and childhood trauma (CT) in BD-I remains limited. This study aimed to investigate the prevalence of BED among euthymic BD-I patients and to examine its associations with CT and clinical characteristics.

Methods: This cross-sectional study recruited 150 euthymic BD-I patients diagnosed according to DSM-5 criteria. Sociodemographic data, illness-related variables, psychiatric comorbidities, and medication use were collected. Binge eating disorder was assessed through the Structured Clinical Interview for DSM-5 (SCID-5) and validated eating disorder scales. Childhood trauma was evaluated using the Childhood Trauma Questionnaire (CTQ). Statistical analyses included group comparisons and multivariate logistic regression.

Results: Binge eating disorder prevalence in the sample was 19.3%. Female sex, higher body weight, and elevated body mass index were significantly associated with BED. Compared to patients without BED, those with BED reported higher rates of psychotic episodes, rapid cycling, and suicide attempts. Childhood trauma questionnaire total scores, particularly physical abuse subscale scores, were significantly higher in the BED group. Logistic regression analysis revealed that female sex, a history of physical abuse, and higher eating disorder scale scores were independent predictors of BED.

Conclusions: Our findings indicate that BED constitutes a distinct and clinically consequential profile in euthymic BD-I patients, one that is strongly shaped by both increased illness severity and CT. This relationship underlines the necessity of integrating systematic assessments of eating pathology and trauma exposure into the standard clinical evaluation of BD-I patients to ensure timely recognition and the delivery of effective, precision-based therapeutic interventions.