Bulimia in a male alcoholic: a symptom substitution in alcoholism.

In recent years, evidence points to a relation between bulimia nervosa and alcoholism. A significant number of bulimics have been reported to abuse alcohol and drugs. Additionally, there is a high prevalence of alcoholism in the families of bulimic patients. In the light of the proposed hypothesis concerning symptom substitution between the dyscontrol syndromes, we present an alcoholic patient who developed bulimic symptoms in the abstinence period. In this patient bulimic manifestations disappeared as he restarted drinking again, suggesting that these two symptoms serve as a substitute for each other.