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Michel EJ, Reich G, Meyer T. Parent-child age gaps in patients with anorexia and bulimia nervosa and their associations with family dysfunction. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024; 38:32-38. [PMID: 36287385 DOI: 10.1007/s40211-022-00433-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Family factors are linked to the development of anorexia nervosa (AN) and bulimia nervosa (BN). However, due to a lack of direct comparison, it is still unknown whether the two entities of eating disorders differ with respect to the age gaps between parents and their affected children. METHODS In a cohort of 568 patients from the FamFINED study (FAMily Factors INvolved in Eating Disorders) diagnosed with eating disorders, we assessed the relationships between the parent-child age differences and family dysfunction, as determined by means of the General Family Questionnaire ("Allgemeiner Familienbogen" [FBA]). RESULTS Data showed that the age difference between the mother and the affected child was significantly higher in AN compared to BN patients (29.3 ± 5.3 vs. 28.3 ± 5.1 years, p = 0.017). Logistic regression confirmed that, also in adjusted models, the mother-child age difference significantly differed between the diagnoses of the two eating disorders (exp (B) = 0.918, 95% confidence interval 0.87-0.97, p = 0.004). However, the paternal age difference did not reach a statistical significance in the comparison between the two groups (p = 0.071). CONCLUSIONS The two entities of eating disorders differed significantly with respect to the age difference between the mother and the affected subject. The maternal age difference was higher in anorectic than in bulimic patients from the same study population. Further research is required to identify the psychophysiological mechanisms underlying these age-dependent effects.
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Affiliation(s)
- Emma Josephine Michel
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, Göttingen, Germany
| | - Günter Reich
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, Göttingen, Germany
| | - Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, Göttingen, Germany.
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Papini NM, Presseller E, Bulik CM, Holde K, Larsen JT, Thornton LM, Albiñana C, Vilhjálmsson BJ, Mortensen PB, Yilmaz Z, Petersen LV. Interplay of polygenic liability with birth-related, somatic, and psychosocial factors in anorexia nervosa risk: a nationwide study. Psychol Med 2024:1-14. [PMID: 38347808 DOI: 10.1017/s0033291724000175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
BACKGROUND Although several types of risk factors for anorexia nervosa (AN) have been identified, including birth-related factors, somatic, and psychosocial risk factors, their interplay with genetic susceptibility remains unclear. Genetic and epidemiological interplay in AN risk were examined using data from Danish nationwide registers. AN polygenic risk score (PRS) and risk factor associations, confounding from AN PRS and/or parental psychiatric history on the association between the risk factors and AN risk, and interactions between AN PRS and each level of target risk factor on AN risk were estimated. METHODS Participants were individuals born in Denmark between 1981 and 2008 including nationwide-representative data from the iPSYCH2015, and Danish AN cases from the Anorexia Nervosa Genetics Initiative and Eating Disorder Genetics Initiative cohorts. A total of 7003 individuals with AN and 45 229 individuals without a registered AN diagnosis were included. We included 22 AN risk factors from Danish registers. RESULTS Risk factors showing association with PRS for AN included urbanicity, parental ages, genitourinary tract infection, and parental socioeconomic factors. Risk factors showed the expected association to AN risk, and this association was only slightly attenuated when adjusted for parental history of psychiatric disorders or/and for the AN PRS. The interaction analyses revealed a differential effect of AN PRS according to the level of the following risk factors: sex, maternal age, genitourinary tract infection, C-section, parental socioeconomic factors and psychiatric history. CONCLUSIONS Our findings provide evidence for interactions between AN PRS and certain risk-factors, illustrating potential diverse risk pathways to AN diagnosis.
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Affiliation(s)
- Natalie M Papini
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Emily Presseller
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Katrine Holde
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
| | - Janne T Larsen
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Clara Albiñana
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Bjarni J Vilhjálmsson
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
- Bioinformatic Research Centre, Aarhus University, Aarhus, Denmark
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Preben B Mortensen
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Liselotte V Petersen
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
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Ozsvar J, Gissler M, Lavebratt C, Nilsson IAK. Exposures during pregnancy and at birth are associated with the risk of offspring eating disorders. Int J Eat Disord 2023; 56:2232-2249. [PMID: 37646613 DOI: 10.1002/eat.24053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Eating disorders (ED) are severe psychiatric disorders, commonly debuting early. Aberrances in the intrauterine environment and at birth have been associated with risk of ED. Here, we explore if, and at what effect size, a variety of such exposures associate with offspring ED, that is, anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS). METHODS This population-based cohort study, conducted from September 2021 to August 2023, used Finnish national registries of all live births in 1996-2014 (N = 1,097,753). Cox proportional hazards modeling was used to compare ED risk in exposed versus unexposed offspring, adjusting for potential confounders and performing sex-stratified analyses. RESULTS A total of 6614 offspring were diagnosed with an ED; 3668 AN, 666 BN, and 4248 EDNOS. Lower risk of offspring AN was seen with young mothers, continued smoking, and instrumental delivery, while higher risk was seen with older mothers, inflammatory disorders, prematurity, small for gestational age, and low Apgar. Offspring risk of BN was higher with continued smoking and prematurity, while lower with postmature birth. Offspring risk of EDNOS was lower with instrumental delivery, higher for older mothers, polycystic ovary syndrome, insulin-treated pregestational diabetes, antibacterial treatment, prematurity, and small for gestational age. Sex-specific associations were found. CONCLUSIONS Several prenatal and at birth exposures are associated with offspring ED; however, we cannot exclude confounding by maternal BMI. Nevertheless, several exposures selectively associate with risk of either AN, BN, or EDNOS, and some are sex-specific, emphasizing the importance of subtype- and sex-stratified analyses of ED. PUBLIC SIGNIFICANCE We define environmental factors involved in the development of different ED, of importance as preventive measure, but also in order to aid in defining the molecular pathways involved and thus in the longer perspective contribute to the development of pharmacological treatment of ED.
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Affiliation(s)
- Judit Ozsvar
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Mika Gissler
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ida A K Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Centre for Eating Disorders Innovation, Karolinska Institutet, Stockholm, Sweden
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Paszynska E, Hernik A, Rangé H, Amaechi BT, Gross GS, Pawinska M. Diet Traps during Eating Disorders among Dentate Patients at an Oral Health Glance. Nutrients 2023; 15:4414. [PMID: 37892489 PMCID: PMC10610111 DOI: 10.3390/nu15204414] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/04/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
Persons suffering from eating disorders (ED) may often experience a recurrence/persistence symptoms despite the completion of psychiatric therapy. In most cases, their general health status is linked to current nutritional behaviors. Medical professionals, general practitioners (GPs), dieticians, and dentists may see those patients in their practices. At the same time, due to low sense of illness, some patients may delay or never seek professional medical care. The aim of this article is to analyze the main ED types according to dietary behaviors causing oral health problems and discuss oral health complications in affected dentate patients. The second objective is to update oral preventive measures and technological innovations together with active agents for oral hygiene care that might effectively support oral health maintenance during the presence of long-term symptoms. The research method involved a review of clinical reports as a synthesis of the electronic research in the Pubmed, Web of Science, and Google Scholar databases. Based on the research, ED patients were found to present related incidences of oral complications. Studies have reported that the possible course of an ED and comorbidities may be an imbalance in the oral environment. The results showed an association between biological (malnutrition, etc.), behavioral (binge eating episodes, vomiting, acidic diet, poor oral hygiene), and pharmacotherapeutic (addiction, hyposalivation) factors that may threaten oral health. Early diagnosis of the past and present symptoms is essential to eliminate and take control of destructive behaviors. Oral changes need to be tackled with medical insight, and additionally, the perception of dietary interactions is recommended.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), 60-812 Poznan, Poland
| | - Amadeusz Hernik
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), 60-812 Poznan, Poland
| | - Hélène Rangé
- Department of Periodontology, Faculty of Odontology, University of Rennes, CHU de Rennes, F-35000 Rennes, France
- Institut NUMECAN (Nutrition Metabolism and Cancer), INSERM, INRAE, University of Rennes, F-35000 Rennes, France
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Georgiana S. Gross
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Malgorzata Pawinska
- Department of Integrated Dentistry, Medical University in Bialystok, 15-276 Bialystok, Poland
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5
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Koch SV, Larsen JT, Plessen KJ, Thornton LM, Bulik CM, Petersen LV. Associations between parental socioeconomic-, family-, and sibling status and risk of eating disorders in offspring in a Danish national female cohort. Int J Eat Disord 2022; 55:1130-1142. [PMID: 35809040 PMCID: PMC9546370 DOI: 10.1002/eat.23771] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Studies on parental socioeconomic status (SES) and family risk factors for eating disorders (EDs) have yielded inconsistent results; however, several studies have identified high parental educational attainment as a risk factor. The aim was to evaluate associations of parental SES and family composition with anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS) in the offspring, adjusting for parental age and parental mental health. METHODS The cohort included women born in Denmark between January 1, 1989 and December 31, 2010, derived from Danish national registers. Each person was followed from their sixth birthday until onset of the disorder of interest or to December 31, 2016. Exposure variables were: childhood SES, defined as individually evaluated parental level of income, occupation, and education; sibling status; and family composition. Outcomes were: AN, BN, EDNOS, and major depressive disorder (MDD), included as a psychiatric comparison disorder. Risks were estimated using Cox proportional hazards. RESULTS High parental SES was associated with increased risk of especially AN, and less so BN and EDNOS, in offspring. In comparison, low SES was associated with a higher risk of MDD. No differences between maternal or paternal socioeconomic risk factors were found. Family composition and sibling status showed limited influence on ED risk. DISCUSSION SES shows opposite associations with AN than MDD, whereas associations with BN and EDNOS are intermediate. The socioeconomic backdrop of AN differs markedly from that reported in other psychiatric disorders. Whether that is due to genetic and/or environmental factors remains unknown. PUBLIC SIGNIFICANCE STATEMENT Parental socioeconomic background (SES) may influence eating disorders risk in offspring somewhat differently than other psychiatric disorders. In Denmark, higher parental SES was associated with increased risk of, particularly, anorexia nervosa (AN). Importantly AN does strike across the SES spectrum. We must ensure that individuals of all backgrounds have equal access to care and are equally likely to be detected and treated appropriately for eating disorders.
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Affiliation(s)
- Susanne Vinkel Koch
- Department of Child and Adolescent PsychiatryCopenhagen University Hospital ‐ Psychiatry Region ZealandCopenhagenDenmark,Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Janne Tidselbak Larsen
- National Centre for Register‐based Research, Aarhus BSSAarhus UniversityAarhusDenmark,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)Aarhus UniversityAarhusDenmark,Centre for Integrated Register‐based Research (CIRRAU)Aarhus UniversityAarhusDenmark
| | - Kerstin J. Plessen
- Division of Child and Adolescent Psychiatry, Department of PsychiatryUniversity Hospital Lausanne, University of LausanneLausanneSwitzerland
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Cynthia M. Bulik
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Liselotte Vogdrup Petersen
- National Centre for Register‐based Research, Aarhus BSSAarhus UniversityAarhusDenmark,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH)Aarhus UniversityAarhusDenmark,Centre for Integrated Register‐based Research (CIRRAU)Aarhus UniversityAarhusDenmark
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Behaviour, Belief and Impairment (BBI): a diagnostic procedure for eating disorders in primary care. Ir J Med Sci 2022:10.1007/s11845-022-03086-8. [PMID: 35838857 DOI: 10.1007/s11845-022-03086-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Eating disorders are becoming increasingly prevalent, especially among adolescents. Recognition and assessment of their clinical presentation can be challenging for clinicians in primary care settings, where consultation time is short and experience with eating disorders is limited. The early detection and appropriate referral of adolescents with eating disorders are essential for timely management. AIM This article reviews eating disorders and the need for a simple, time-efficient assessment which could be used in primary care settings. OUTCOME The authors propose a unique model of assessment entitled Behaviour, Belief and Impairment or BBI, which provides a simple, time-efficient assessment that can assist in the early detection of an eating disorder. The BBI assessment model conceptualises eating disorders in three domains: the observed behaviour, the underlying belief of the patient that drives the behaviour and the subsequent physical or psychological impairment.
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7
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Yilmaz Z, Larsen JT, Nissen JB, Crowley JJ, Mattheisen M, Bulik CM, Petersen LV. The role of early-life family composition and parental socio-economic status as risk factors for obsessive-compulsive disorder in a Danish national cohort. J Psychiatr Res 2022; 149:18-27. [PMID: 35219872 PMCID: PMC9627644 DOI: 10.1016/j.jpsychires.2022.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/02/2022] [Accepted: 02/14/2022] [Indexed: 01/16/2023]
Abstract
Research on early-life family environment on obsessive-compulsive disorder (OCD) risk is limited, and sex differences have not been sufficiently studied. We investigated early-life family composition and parental socio-economic status (SES) as OCD risk factors while stratifying for sex in a sample of 1,154,067 individuals from the Danish population (7550 of whom had OCD). Data on early-life family composition (birth order, number of siblings, number of parents in household at proband age 6), parental SES at age 6 (parental income, occupation, and education level), history of parental psychiatric illness, and parental age at birth on OCD risk (i.e., an ICD-10 diagnosis of F42.x) were obtained from Danish population registers. Survival analyses using Cox regression were performed with age as the underlying time variable. Analyses were adjusted for calendar time, and differential effect by sex was tested for exposures. We found that birth order and advanced maternal age were risk factors for OCD in males, and being an only child was associated with increased OCD risk in both sexes. Early childhood SES variables including parental education, occupation, and income were associated with OCD risk, and these effects were more pronounced in females. Significant interaction effects for parental education/occupation and the presence of non-OCD psychiatric diagnoses in the proband also emerged. Our results suggest that early-life SES and family composition may be important risk factors for OCD, and heterogeneity in OCD cases in terms of psychiatric comorbidities, as well as sex differences should be carefully examined in relation to risk factors.
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Affiliation(s)
- Zeynep Yilmaz
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, 8210, Denmark; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 27599-7160; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden.
| | - Janne Tidselbak Larsen
- National Centre for Register-based Research, Aarhus BSS,
Aarhus University, Aarhus, Denmark, 8210,Lundbeck Foundation Initiative for Integrative Psychiatric
Research (iPSYCH), Aarhus University, Aarhus, Denmark, 8000,Centre for Integrated Register-based Research (CIRRAU),
Aarhus University, Aarhus, Denmark, 8210
| | - Judith Becker Nissen
- Department of Child and Adolescent Psychiatry, Aarhus
University Hospital, Aarhus, Denmark, 8200
| | - James J. Crowley
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7160,Department of Genetics, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7264,Department of Clinical Neuroscience, Karolinska Institutet,
Stockholm, Sweden, 171 77
| | - Manuel Mattheisen
- Lundbeck Foundation Initiative for Integrative Psychiatric
Research (iPSYCH), Aarhus University, Aarhus, Denmark, 8000,Department of Clinical Neuroscience, Karolinska Institutet,
Stockholm, Sweden, 171 77,Department of Biomedicine, Aarhus University, Aarhus,
Denmark, 8000,Department of Psychiatry, Dalhousie University, Halifax,
Nova Scotia, Canada, B3H 2E2
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7160,Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, Stockholm, Sweden, 171 77,Department of Nutrition, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7400
| | - Liselotte Vogdrup Petersen
- National Centre for Register-based Research, Aarhus BSS,
Aarhus University, Aarhus, Denmark, 8210,Lundbeck Foundation Initiative for Integrative Psychiatric
Research (iPSYCH), Aarhus University, Aarhus, Denmark, 8000,Centre for Integrated Register-based Research (CIRRAU),
Aarhus University, Aarhus, Denmark, 8210
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Talmon A, Widom CS. Childhood Maltreatment and Eating Disorders: A Prospective Investigation. CHILD MALTREATMENT 2022; 27:88-99. [PMID: 33525891 DOI: 10.1177/1077559520988786] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To determine whether childhood maltreatment is a risk factor for two eating disorders (anorexia nervosa and bulimia nervosa) using objective and subjective case definitions. METHODS Using a prospective cohorts design, children with documented cases of physical abuse, sexual abuse, and neglect (ages 0-11) from 1967 to 1971 in a Midwestern metropolitan county area were matched on age, race, sex, and approximate family socioeconomic status with non-maltreated children. Both groups were followed up. Retrospective self-reports about childhood maltreatment were collected at age 29. DSM-IV anorexia nervosa (AN) and bulimia nervosa (BN) disorders were assessed at age 41 (N = 807). Logistic and linear regression results are reported. RESULTS Using documented cases, childhood maltreatment was not a significant risk factor for AN or BN diagnoses or symptoms in adulthood. However, adults who retrospectively reported any maltreatment and physical and sexual abuse reported significantly more symptoms of AN than those who did not. CONCLUSIONS The prediction that childhood maltreatment is a risk factor for anorexia nervosa and bulimia nervosa was partially supported in this longitudinal study. While misattribution of cases might have occurred, these results suggest that researchers and clinicians should use caution in drawing inferences about these relationships and designing interventions.
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Affiliation(s)
- Anat Talmon
- Psychology Department, 6429Stanford University, Stanford, CA, USA
| | - Cathy Spatz Widom
- Psychology Department, 14775John Jay College, and Graduate Center, City University of New York, NY, USA
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9
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Huryk KM, Drury CR, Loeb KL. Diseases of affluence? A systematic review of the literature on socioeconomic diversity in eating disorders. Eat Behav 2021; 43:101548. [PMID: 34425457 DOI: 10.1016/j.eatbeh.2021.101548] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 06/01/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
The stereotype that eating disorders (ED) primarily present among individuals of higher socioeconomic status (SES) has long persisted in popular and professional perception. This belief has likely contributed to disparities in ED identification and treatment, particularly among those of lower SES backgrounds. The objective of this article was to systematically review the literature investigating socioeconomic diversity in distinct ED diagnoses. A PRISMA search was conducted to identify studies that empirically assessed the association between ED pathology and indicators of SES via PubMed and PsycINFO. This search generated 13,538 articles, of which 62 articles published between 1973 and August 2020 met criteria for inclusion in the review. Included studies were primarily cross-sectional and covered diagnoses of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), with quality ratings of poor, fair, and good. Results are examined in the context of studies' sampling methods, operationalization of SES, and statistical analyses. There is no consistent pattern of evidence to suggest a relationship between high SES and ED. Instead, all ED present across a wide range of socioeconomic backgrounds. Limitations included the predominance of cross-sectional study designs and poor to fair quality ratings. Future research should include adequately powered, community-based longitudinal studies that examine how sociocultural factors, including SES, intersect to influence ED risk and treatment outcome. The existing data suggest an urgent need to prioritize affordable and accessible ED treatment.
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Affiliation(s)
- Kathryn M Huryk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Catherine R Drury
- School of Psychology, Fairleigh Dickinson University, 1000 River Road, T-WH1-01, Teaneck, NJ 07666, USA.
| | - Katharine L Loeb
- Chicago Center for Evidence-Based Treatment, 25 E Washington St, Suite 1015, Chicago, IL 60602, USA.
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10
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Tauro JL, Wearne TA, Belevski B, Filipčíková M, Francis HM. Social cognition in female adults with Anorexia Nervosa: A systematic review. Neurosci Biobehav Rev 2021; 132:197-210. [PMID: 34822877 DOI: 10.1016/j.neubiorev.2021.11.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 12/26/2022]
Abstract
Deficits in interpersonal and social functioning are well established in females with Anorexia Nervosa (AN), and are thought to be key features involved in the onset and maintenance of the disease. Growing literature suggests these may be attributed to poor social cognitive processes. This systematic review evaluates whether differences in social cognition exist in adult females with AN. A total of 32 studies that compared females with AN against a healthy control group using social cognitive measures and/or questionnaires were analysed. The majority of studies were deemed to have a low or moderate risk of bias. Overall, empathy appears to be intact in AN, however greater emotion regulation difficulties, elevated alexithymia and reduced emotional awareness are evident in AN. Findings relating to emotion recognition and emotional Theory of Mind were inconsistent. The nature of the task appeared to influence the domains of cognitive ToM and social perception, warranting further research. These findings are discussed within the broader context of social cognitive models and AN rehabilitation.
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Affiliation(s)
- Joanna L Tauro
- Department of Psychology, Macquarie University, NSW, 2109, Australia.
| | - Travis A Wearne
- School of Psychology, Faculty of Science, University of New South Wales, NSW, 2052, Australia
| | - Bianca Belevski
- Department of Psychology, Macquarie University, NSW, 2109, Australia
| | - Michaela Filipčíková
- School of Psychology, Faculty of Science, University of New South Wales, NSW, 2052, Australia
| | - Heather M Francis
- Department of Psychology, Macquarie University, NSW, 2109, Australia
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11
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Genetic correlates of socio-economic status influence the pattern of shared heritability across mental health traits. Nat Hum Behav 2021. [PMID: 33686200 DOI: 10.1038/s41562-021-01053-4.genetic] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Epidemiological studies show high comorbidity between different mental health problems, indicating that individuals with a diagnosis of one disorder are more likely to develop other mental health problems. Genetic studies reveal substantial sharing of genetic factors across mental health traits. However, mental health is also genetically correlated with socio-economic status (SES), and it is therefore important to investigate and disentangle the genetic relationship between mental health and SES. We used summary statistics from large genome-wide association studies (average N ~ 160,000) to estimate the genetic overlap across nine psychiatric disorders and seven substance use traits and explored the genetic influence of three different indicators of SES. Using genomic structural equation modelling, we show significant changes in patterns of genetic correlations after partialling out SES-associated genetic variation. Our approach allows the separation of disease-specific genetic variation and genetic variation shared with SES, thereby improving our understanding of the genetic architecture of mental health.
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Marees AT, Smit DJ, Abdellaoui A, Nivard MG, van den Brink W, Denys D, Galama TJ, Verweij KJ, Derks EM. Genetic correlates of socio-economic status influence the pattern of shared heritability across mental health traits. Nat Hum Behav 2021; 5:1065-1073. [PMID: 33686200 PMCID: PMC8376746 DOI: 10.1038/s41562-021-01053-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 01/13/2021] [Indexed: 01/31/2023]
Abstract
Epidemiological studies show high comorbidity between different mental health problems, indicating that individuals with a diagnosis of one disorder are more likely to develop other mental health problems. Genetic studies reveal substantial sharing of genetic factors across mental health traits. However, mental health is also genetically correlated with socio-economic status (SES), and it is therefore important to investigate and disentangle the genetic relationship between mental health and SES. We used summary statistics from large genome-wide association studies (average N ~ 160,000) to estimate the genetic overlap across nine psychiatric disorders and seven substance use traits and explored the genetic influence of three different indicators of SES. Using genomic structural equation modelling, we show significant changes in patterns of genetic correlations after partialling out SES-associated genetic variation. Our approach allows the separation of disease-specific genetic variation and genetic variation shared with SES, thereby improving our understanding of the genetic architecture of mental health.
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Affiliation(s)
- Andries T. Marees
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands,QIMR Berghofer, Translational Neurogenomics group, Brisbane, Queensland, Australia,Department of Economics, School of Business and Economics, VU University Amsterdam, Amsterdam, the Netherlands,Correspondence: Andries T. Marees () Eske M. Derks ()
| | - Dirk J.A. Smit
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Abdel Abdellaoui
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Michel G. Nivard
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Titus J. Galama
- Department of Economics, School of Business and Economics, VU University Amsterdam, Amsterdam, the Netherlands,University of Southern California, Dornsife Center for Economic and Social Research (CESR), Los Angeles, CA, USA,Erasmus School of Economics, Erasmus University, Rotterdam, The Netherlands
| | - Karin J.H. Verweij
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Eske M. Derks
- QIMR Berghofer, Translational Neurogenomics group, Brisbane, Queensland, Australia,Correspondence: Andries T. Marees () Eske M. Derks ()
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Stein K, Warne N, Heron J, Zucker N, Bould H. Do children with recurrent abdominal pain grow up to become adolescents who control their weight by fasting? Results from a UK population-based cohort. Int J Eat Disord 2021; 54:915-924. [PMID: 33939186 PMCID: PMC8344098 DOI: 10.1002/eat.23513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/04/2021] [Accepted: 03/23/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Gastrointestinal (GI) problems are common in eating disorders, but it is unclear whether these problems predate the onset of disordered eating. Recurrent abdominal pain (RAP) is the most prevalent GI problem of childhood, and this study aimed to explore longitudinal associations between persistent RAP (at ages 7 and 9) and fasting for weight control at 16. METHOD The Avon Longitudinal Study of Parents and Children (ALSPAC) is a UK population cohort of children. Childhood RAP was reported by mothers and defined as RAP 5+ (5 pain episodes in the past year) in our primary analysis, and RAP 3+ (3 pain episodes) in our sensitivity analysis. Fasting for weight control was reported by adolescents at 16. We used logistic regression models to examine associations, with adjustments for potential confounders. RESULTS After adjustments, we found no association between childhood RAP 5+ and adolescent fasting for weight control at 16 (OR 1.30 (95% Confidence Intervals [CI] 0.87, 1.94) p = .197). However, we did find an association between RAP 3+ and later fasting, in the fully adjusted model (OR 1.50 [95% CI 1.16, 1.94] p = .002), and after excluding those with pre-existing anxiety (OR 1.52 [95% CI 1.17, 1.97] p = .002). DISCUSSION Our findings suggest a possible independent contribution of RAP to later risk of fasting for weight control, and RAP should be enquired about in the assessment of eating disorders. However, frequency of childhood abdominal pain (as captured by ALSPAC) may be less important to long-term outcomes than functional impairment.
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Affiliation(s)
- K. Stein
- Academic Clinical Fellow in Child and Adolescent Psychiatry, University of Oxford; Warneford Hospital, Oxford OX3 7JX
| | - N. Warne
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN
| | - J. Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN
| | - N. Zucker
- Associate Professor of Clinical Psychology, Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - H. Bould
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN & Gloucestershire Health and Care NHS Foundation Trust, Gloucester, UK
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Marzola E, Cavallo F, Panero M, Porliod A, Amodeo L, Abbate-Daga G. The role of prenatal and perinatal factors in eating disorders: a systematic review. Arch Womens Ment Health 2021; 24:185-204. [PMID: 32767123 PMCID: PMC7979621 DOI: 10.1007/s00737-020-01057-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/20/2020] [Indexed: 12/30/2022]
Abstract
Numerous studies showed that factors influencing fetal development and neonatal period could lead to lasting alterations in the brain of the offspring, in turn increasing the risk for eating disorders (EDs). This work aims to systematically and critically review the literature on the association of prenatal and perinatal factors with the onset of EDs in the offspring, updating previous findings and focusing on anorexia nervosa (AN) and bulimia nervosa (BN). A systematic literature search was performed on Pubmed, PsycINFO, and Scopus. The drafting of this systematic review was conducted following the PRISMA statement criteria and the methodological quality of each study was assessed by the MMAT 2018. A total of 37 studies were included in this review. The factors that showed a more robust association with AN were higher maternal age, preeclampsia and eclampsia, multiparity, hypoxic complications, prematurity, or being born preterm (< 32 weeks) and small for gestational age or lower birth size. BN was only associated with maternal stress during pregnancy. Many methodological flaws emerged in the considered studies, so further research is needed to clarify these inconsistencies. Altogether, data are suggestive of an association between prenatal and perinatal factors and the onset of EDs in the offspring. Nevertheless, given the methodological quality of the available literature, firm conclusions cannot be drawn and whether this vulnerability is specific to EDs or mental disorders remains to be defined. Also, a strong need for longitudinal and well-designed studies on this topic emerged.
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Affiliation(s)
- Enrica Marzola
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
| | - Fabio Cavallo
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
| | - Matteo Panero
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
| | - Alain Porliod
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
| | - Laura Amodeo
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
| | - Giovanni Abbate-Daga
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
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15
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Yang J, Han KS. A rational emotive behavior therapy-based intervention for binge eating behavior management among female students: a quasi-experimental study. J Eat Disord 2020; 8:65. [PMID: 33292605 PMCID: PMC7709400 DOI: 10.1186/s40337-020-00347-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/28/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Binge eating behavior is highly likely to progress to an eating disorder, with female students particularly at risk. OBJECTIVE This study aimed to verify the effect of a binge eating behavior management program, based on rational emotive behavior therapy (REBT), on binge eating behavior and related cognitive and emotional factors among female college students. METHOD The study, conducted from November 1 to December 2, 2016, involved a pretest-posttest design and nonequivalent control group. The sample included 24 and 22 first- to third-year students, from a college in South Korea, in the experimental and control groups, respectively. Data were collected using self-esteem, covert narcissism, perfectionism, body dissatisfaction, anxiety, depression, and binge eating scales and analyzed via frequency analysis, χ2 tests, t tests, and analysis of covariance. RESULTS The results indicated that the REBT-based binge eating behavior management program exerted positive effects on participants' self-esteem, reducing covert narcissism, body dissatisfaction, anxiety, depression, and binge eating. However, there was no significant difference in perfectionism, although the experimental group's mean score decreased from pretest to posttest. CONCLUSIONS Based on the results, the program was considered to be effective, and is expected to be useful in preventing the development of eating disorders among female college students by treating binge eating behavior and related cognitive and emotional factors. This intervention could ultimately contribute to the improvement of female college students' health and quality of life.
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Affiliation(s)
- Jiwon Yang
- Department of Nursing, Kyungil University, Gyeongsan-si, South Korea
| | - Kuem Sun Han
- Department of Nursing, Korea University, Seoul, South Korea.
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16
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Improving School Mental Health Services for Students with Eating Disorders. SCHOOL MENTAL HEALTH 2020. [DOI: 10.1007/s12310-020-09387-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Rossman SM, Eddy KT, Franko DL, Rose J, DuBois R, Weissman RS, Dierker LC, Thomas JJ. Behavioral symptoms of eating disorders among adopted adolescents and young adults in the United States: Findings from the Add Health survey. Int J Eat Disord 2020; 53:1515-1525. [PMID: 32701179 DOI: 10.1002/eat.23334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE More adopted individuals report experiencing general psychopathology, poor parental attachment, and early childhood eating difficulties than nonadopted individuals, yet little is known about disordered eating in this population. This study sought to describe the relationship between adoption status and behavioral eating-disorder (ED) symptoms, and to examine potential correlates of ED symptoms that are unique to adopted individuals. METHOD We examined data from adolescents and young adults from Waves 1 (n adopted = 561, nonadopted = 20,184), 2 (n adopted = 211, nonadopted = 14,525), and 3 (n adopted = 416, nonadopted = 14,754) of the National Longitudinal Study of Adolescent to Adult Health. ED symptom items included dieting, breakfast skipping, binge eating, extreme weight loss behaviors (EWLBs; i.e., self-induced vomiting, laxative use, diet pill use) and lifetime ED diagnosis. RESULTS Compared to nonadopted individuals, adopted individuals were more likely to report EWLBs at Wave 2 and binge eating and lifetime ED diagnosis at Wave 3 (ps < .05). Among adopted individuals, contact with a biological parent was associated with higher rates of binge eating and lifetime ED diagnosis at Wave 3 (ps < .05), whereas age at adoption and having ever been in foster care were not associated with rates of ED symptoms. DISCUSSION This study provides preliminary evidence that being adopted may be a risk factor for certain behavioral symptoms of EDs. Given the benefits of early detection and treatment of ED symptoms, mental health professionals working with adopted individuals should assess for disordered eating.
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Affiliation(s)
- Setareh M Rossman
- Department of Psychology, Clark University, Worcester, Massachusetts, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Debra L Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Jennifer Rose
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
| | - Russell DuBois
- Department of Clinical Research, Blueprint Health, Chicago, Illinois, USA
| | | | - Lisa C Dierker
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Watson HJ, Diemer EW, Zerwas S, Gustavson K, Knudsen GP, Torgersen L, Reichborn-Kjennerud T, Bulik CM. Prenatal and perinatal risk factors for eating disorders in women: A population cohort study. Int J Eat Disord 2019; 52:643-651. [PMID: 30891792 PMCID: PMC6644683 DOI: 10.1002/eat.23073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 03/02/2019] [Accepted: 03/02/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The fetal programming model hypothesizes that developmental programming in utero and in early life induces adaptations that predetermine the adult phenotype. This study investigated whether prenatal/perinatal complications are associated with lifetime eating disorders in women. METHOD Participants included 46,373 adult women enrolled in the Norwegian Mother and Child Cohort Study (den norske Mor & barn-undersøkelsen [MoBa]). MoBa mothers and their mothers (MoBa grandmothers) were the focus of the current study. MoBa mothers with lifetime eating disorders were compared to a referent group. RESULTS MoBa mothers who weighed more at birth (birth weight, adjusted odds ratio [OR] = 1.14; 95% confidence interval [CI]: 1.10-1.19) or were born large-for-gestational-age (adjusted OR = 1.39; 95% CI: 1.27-1.52) were more likely to develop binge-eating disorder in later life. MoBa mothers who weighed less at birth were more likely to develop anorexia nervosa (birth weight, adjusted OR = 0.88; 95% CI: 0.81-0.95). Bulimia nervosa and purging disorder (PD) were not significantly predicted by the prenatal and perinatal factors examined. DISCUSSION Results of this study, which include the first known investigation of prenatal and perinatal factors in binge-eating disorder and PD, suggest that fetal programming may be relevant to the development of anorexia nervosa and binge-eating disorder. Future genetically informative research is needed to help disentangle whether these associations are a function of genetic influences or a true environmental fetal programming effect.
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Affiliation(s)
- Hunna J. Watson
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, United States,School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia,School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Elizabeth W. Diemer
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, United States
| | - Stephanie Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Kristin Gustavson
- Department of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway,Department of Psychology, University of Oslo, Oslo, Norway
| | - Gun Peggy Knudsen
- Department of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Leila Torgersen
- Department of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Division of Mental Health Services, Akershus University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Norway
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, United States,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, United States,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Larsen PS, Strandberg-Larsen K, Olsen EM, Micali N, Nybo Andersen AM. Parental characteristics in association with disordered eating in 11- to 12-year-olds: A study within the Danish National Birth Cohort. EUROPEAN EATING DISORDERS REVIEW 2018; 26:315-328. [PMID: 29700895 DOI: 10.1002/erv.2599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/15/2018] [Accepted: 03/25/2018] [Indexed: 01/12/2023]
Abstract
We examined the association between parental characteristics and disordered eating among 11- to 12-year-olds within the Danish National Birth Cohort. Frequency of fasting, purging, and binge eating was obtained by self-report from 37,592 children and combined into a measure of disordered eating (no, monthly, and weekly). Information on parental characteristics was obtained during pregnancy, from the 7-year follow-up, and by linkage to population registers. Data were analysed using multinomial logistic regression models with robust standard errors. In total, 3.1% reported weekly and 4.1% reported monthly disordered eating. Parental young age, low educational level, and overweight/obesity were associated with disordered eating. The relative risk ratios for, respectively, weekly and monthly disordered eating according to maternal eating disorder were 1.01 [0.75, 1.37] and 1.09 [0.84, 1.42]. Disordered eating is common among children and is associated with several parental characteristics. We found social inequality in disordered eating, but our data did not support an association with maternal eating disorder.
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Affiliation(s)
- Pernille Stemann Larsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Else Marie Olsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Healthcare Services, Research Centre for Prevention and Health, Capital Region, Denmark
| | - Nadia Micali
- UCL - Great Ormond Street Institute of Child Health, London, UK.,Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland.,Child and Adolescent Psychiatry Division, Department de 'enfant et de l'adolescent, HUG, Geneva, Switzerland
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Kendler KS, Ohlsson H, Keefe RSE, Sundquist K, Sundquist J. The joint impact of cognitive performance in adolescence and familial cognitive aptitude on risk for major psychiatric disorders: a delineation of four potential pathways to illness. Mol Psychiatry 2018; 23:1076-1083. [PMID: 28416810 PMCID: PMC5647225 DOI: 10.1038/mp.2017.78] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 02/22/2017] [Accepted: 02/24/2017] [Indexed: 12/24/2022]
Abstract
How do joint measures of premorbid cognitive ability and familial cognitive aptitude (FCA) reflect risk for a diversity of psychiatric and substance use disorders? To address this question, we examined, using Cox models, the predictive effects of school achievement (SA) measured at age 16 and FCA-assessed from SA in siblings and cousins, and educational attainment in parents-on risk for 12 major psychiatric syndromes in 1 140 608 Swedes born 1972-1990. Four developmental patterns emerged. In the first, risk was predicted jointly by low levels of SA and high levels of FCA-that is a level of SA lower than would be predicted from the FCA. This pattern was strongest in autism spectrum disorders and schizophrenia, and weakest in bipolar illness. In these disorders, a pathologic process seems to have caused cognitive functioning to fall substantially short of familial potential. In the second pattern, seen in the internalizing conditions of major depression and anxiety disorders, risk was associated with low SA but was unrelated to FCA. Externalizing disorders-drug abuse and alcohol use disorders-demonstrated the third pattern, in which risk was predicted jointly by low SA and low FCA. The fourth pattern, seen in eating disorders, was directly opposite of that observed in externalizing disorders with risk associated with high SA and high FCA. When measured together, adolescent cognitive ability and FCA identified four developmental patterns leading to diverse psychiatric disorders. The value of cognitive assessments in psychiatric research can be substantially increased by also evaluating familial cognitive potential.
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Affiliation(s)
- KS Kendler
- Department of Psychiatry, Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond VA, USA,Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - H Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - RSE Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - K Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - J Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
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21
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Landstedt E, Hammarström A, Fairweather-Schmidt AK, Wade T. Associations between adolescent risk for restrictive disordered eating and long-term outcomes related to somatic symptoms, body mass index, and poor well-being. Br J Health Psychol 2018; 23:496-518. [DOI: 10.1111/bjhp.12301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 01/25/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | - Anne Hammarström
- Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
| | | | - Tracey Wade
- School of Psychology; Flinders University; Adelaide South Australia Australia
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22
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Kim Y, Austin SB, Subramanian SV, Thomas JJ, Eddy KT, Franko DL, Rodgers RF, Kawachi I. Risk factors for disordered weight control behaviors among Korean adolescents: Multilevel analysis of the Korea Youth Risk Behavior Survey. Int J Eat Disord 2018; 51:124-138. [PMID: 29341246 DOI: 10.1002/eat.22820] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/17/2017] [Accepted: 12/18/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate the prevalence and risk factors for disordered weight control behaviors (DWCB) in South Korean adolescents at multiple levels, including individual, family, school, and geographic area. METHOD We drew participants from the 11th Korea Youth Risk Behavior Web-based Survey, conducted in 2015, with 65,529 adolescents (31,687 girls, 33,842 boys) aged 12-18 years. DWCB was defined as engaging in any of the following behaviors for weight control over the past month: fasting, one-food diet (eating only one food over an extended period of time for weight control), vomiting, and taking laxatives/diuretics/unprescribed diet pills. Sex-stratified four-level multilevel logistic models examined potential predictors of DWCB, including age, body-mass index, puberty, perceived household economic status, parental education, living structure, school type and sex-composition, percentage of students participating in school nutrition programs, and urbanicity. RESULTS Overall, 6.2% of Korean adolescents (8.9% of girls, 3.7% of boys) exhibited any DWCB. We found significant between-school variation among girls and boys and between-classroom variation among girls. Older age, overweight/obesity, pubertal maturity, high household economic status (vs. mid-range economic status), and vocational schooling (vs. general) were positively associated with DWCB among girls and boys. Low household economic status (vs. mid-range economic status), higher parental education, and coeducational schooling (vs. single-sex) were positively associated with DWCB among girls only. DISCUSSION The findings suggest that DWCB are prevalent among Korean adolescents across age, sex, and socioeconomic status. Social contextual factors including school and familial environmental factors, as well as individual characteristics, should be considered when developing effective prevention strategies.
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Affiliation(s)
- Yongjoo Kim
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Debra L Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Bouvé College of Health Sciences, Department of Applied Psychology, Northeastern University, Boston, Massachusetts
| | - Rachel F Rodgers
- Bouvé College of Health Sciences, Department of Applied Psychology, Northeastern University, Boston, Massachusetts
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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23
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Do disordered eating behaviours in girls vary by school characteristics? A UK cohort study. Eur Child Adolesc Psychiatry 2018; 27:1473-1481. [PMID: 29546694 PMCID: PMC6447693 DOI: 10.1007/s00787-018-1133-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 02/23/2018] [Indexed: 10/31/2022]
Abstract
Previous research on eating disorders, disordered eating behaviours, and whether their prevalence varies across schools, has produced inconsistent results. Our previous work using Swedish record-linkage data found that rates of diagnosed eating disorders vary between schools, with higher proportions of girls and higher proportions of highly educated parents within a school being associated with greater numbers of diagnosed eating disorders. We aimed to extend these findings to a UK population-based sample and hypothesised that a similar association would be evident when studying disordered eating behaviours. We used data from the Avon Longitudinal Study of Parents and Children to test the hypothesis that prevalence of self- and parent-reported disordered eating behaviours (binge eating, purging, fasting, restrictive eating, and fear of weight gain), and body dissatisfaction cluster by school. We had complete data on body dissatisfaction, school attended, and other possible risk factors for 2146 girls in 263 schools at age 14 and on disordered eating behaviours for 1769 girls in 273 schools at age 16. We used multilevel logistic regression modelling to assess whether prevalence varied between and within schools, and logistic regression to investigate the association between specific school characteristics and prevalence of disordered eating behaviours and body dissatisfaction. At age 14, there was no evidence for body dissatisfaction clustering by school, or for specific school characteristics being associated with body dissatisfaction. At age 16, there was no evidence for clustering, but higher rates of disordered eating behaviours were associated with attending all-girl schools and lower levels with attending schools with higher academic results. We found no evidence for clustering of disordered eating behaviours in individual schools, possibly because of the small cluster sizes. However, we found evidence for higher levels of disordered eating behaviours in 16 years in all-girl schools, and in schools with lower academic performance.
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Rosen E, Bakshi N, Watters A, Rosen HR, Mehler PS. Hepatic Complications of Anorexia Nervosa. Dig Dis Sci 2017; 62:2977-2981. [PMID: 28932925 DOI: 10.1007/s10620-017-4766-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 09/13/2017] [Indexed: 12/13/2022]
Abstract
Anorexia nervosa (AN) has the highest mortality rate of all psychiatric illnesses due to the widespread organ dysfunction caused by the underlying severe malnutrition. Starvation causes hepatocyte injury and death leading to a rise in aminotransferases. Malnutrition-induced hepatitis is common among individuals with AN especially as body mass index decreases. Acute liver failure associated with coagulopathy and encephalopathy can rarely occur. Liver enzymes may also less commonly increase as part of the refeeding process due to hepatic steatosis and can be distinguished from starvation hepatitis by the finding of a fatty liver on ultrasonography. Individuals with AN and starvation-induced hepatitis are at increased risk of hypoglycemia due to depleted glycogen stores and impaired gluconeogenesis. Gastroenterology and hepatology consultations are often requested when patients with AN and signs of hepatitis are hospitalized. It should be noted that additional laboratory testing, imaging, or liver biopsy all have low diagnostic yield, are costly, and potentially invasive, therefore, not generally recommended for diagnostic purposes. While the hepatitis of AN can reach severe levels, a supervised increase in caloric intake and a return to a healthy body weight often quickly lead to normalization of elevated aminotransferases caused by starvation.
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Affiliation(s)
- Elissa Rosen
- Department of Medicine, University of Colorado, School of Medicine, 12631 E 17th Ave B178, Aurora, CO, 80045, USA. .,Department of Medicine, Denver Health Hospital, 777 Bannock Street, MC 4000, Denver, CO, 80204, USA. .,ACUTE Center for Eating Disorders at Denver Health, 777 Bannock Street 5A, Denver, CO, 80204, USA.
| | - Neeru Bakshi
- Eating Recovery Center of Washington, 1231 116th Ave NE #800, Bellevue, WA, 98004, USA
| | - Ashlie Watters
- Department of Medicine, Denver Health Hospital, 777 Bannock Street, MC 4000, Denver, CO, 80204, USA.,ACUTE Center for Eating Disorders at Denver Health, 777 Bannock Street 5A, Denver, CO, 80204, USA
| | - Hugo R Rosen
- Department of Medicine, University of Colorado, School of Medicine, 12631 E 17th Ave B178, Aurora, CO, 80045, USA.,Division Head of the Department of Gastroenterology and Hepatology, University of Colorado, School of Medicine, 12631 E 17th Ave B158, Aurora, CO, 80045, USA
| | - Philip S Mehler
- Department of Medicine, University of Colorado, School of Medicine, 12631 E 17th Ave B178, Aurora, CO, 80045, USA.,Department of Medicine, Denver Health Hospital, 777 Bannock Street, MC 4000, Denver, CO, 80204, USA.,ACUTE Center for Eating Disorders at Denver Health, 777 Bannock Street 5A, Denver, CO, 80204, USA.,Eating Recovery Center of Denver, 1830 Franklin St #405, Denver, CO, 80218, USA.,Eating Recovery Center of Washington, 1231 116th Ave NE #800, Bellevue, WA, 98004, USA
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25
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Fetal programming and eating disorder risk. J Theor Biol 2017; 428:26-33. [DOI: 10.1016/j.jtbi.2017.05.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 04/06/2017] [Accepted: 05/23/2017] [Indexed: 11/23/2022]
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Avsar G, Ham R, Tannous WK. Modelling Gender Differences in the Economic and Social Influences of Obesity in Australian Young People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030257. [PMID: 28273825 PMCID: PMC5369093 DOI: 10.3390/ijerph14030257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/03/2017] [Accepted: 02/20/2017] [Indexed: 01/16/2023]
Abstract
In Australia, as in many other developed economies, the prevalence of obesity has risen significantly in all age groups and especially in young males and females over the past decade. Using data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, this paper investigates the influence of economic, personality and social factor demographics on the incidence of obesity in Australian youths. The study uses two random parameters logit models, including one that allows for gender-specific differences in the conditioning variables. The models reveal notable differences between the most important variables affecting the incidence of obesity amongst females compared to males. These differences are notable to consider for policy and intervention programs aimed at reducing the problem of obesity.
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Affiliation(s)
- Gulay Avsar
- School of Business, Western Sydney University, Sydney 2751, Australia.
| | - Roger Ham
- School of Business, Western Sydney University, Sydney 2751, Australia.
| | - W Kathy Tannous
- School of Business, Western Sydney University, Sydney 2751, Australia.
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27
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Nahum Sacks K, Friger M, Shoham-Vardi I, Abokaf H, Spiegel E, Sergienko R, Landau D, Sheiner E. Prenatal exposure to gestational diabetes mellitus as an independent risk factor for long-term neuropsychiatric morbidity of the offspring. Am J Obstet Gynecol 2016; 215:380.e1-7. [PMID: 27018463 DOI: 10.1016/j.ajog.2016.03.030] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 03/17/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The reported rates of gestational diabetes mellitus are constantly escalating and little is known about long-term complications in the offspring. Evidence from the field of epigenetics strongly advocates the need for research on the neuropsychiatric complications in offspring prenatally exposed to gestational diabetes mellitus. OBJECTIVE We sought to assess whether in utero exposure to gestational diabetes mellitus increases the risk of long-term neuropsychiatric morbidity in the offspring. STUDY DESIGN A population-based cohort study compared the incidence of hospitalizations due to neuropsychiatric disease between singletons exposed and unexposed to gestational diabetes mellitus. Deliveries occurred in the years 1991 through 2014 in a regional tertiary medical center. Perinatal deaths, multiple gestations, mothers with pregestational diabetes or lack of prenatal care, and children with congenital malformations were excluded from the study. A multivariate generalized estimating equation logistic regression model analysis was used to control for confounders and for maternal clusters. RESULTS During the study period 231,271 deliveries met the inclusion criteria; 5.4% of the births were to mothers diagnosed with gestational diabetes mellitus (n = 12,642), of these 4.3% had gestational diabetes type A1 (n = 10,076) and 1.1% had gestational diabetes type A2 (n = 2566). During the follow-up period, a significant linear association was noted between the severity of the gestational diabetes (no gestational diabetes, gestational diabetes mellitus A1, gestational diabetes mellitus A2) and neuropsychiatric disease of the offspring (1.02% vs 1.36% vs 1.68%, respectively, P < .001). A Kaplan-Meier curve demonstrated that children born to women with gestational diabetes mellitus had higher cumulative incidence of neuropsychiatric morbidity. Using a generalized estimating equation multivariable logistic regression model, controlling for time-to-event, maternal age, gestational age at delivery, maternal obesity, maternal preeclampsia and fertility treatments, maternal gestational diabetes mellitus was found to be an independent risk factor for long-term neuropsychiatric disease of the offspring (gestational diabetes mellitus A1 [adjusted odds ratio, 1.83; 95% confidence interval, 1.53-2.19] and gestational diabetes mellitus A2 [adjusted odds ratio, 1.64; 95% confidence interval, 1.18-2.27]). Within the limits of our database, our findings also point to a possible association between in utero exposure to gestational diabetes mellitus and autistic spectrum disorder of the offspring (adjusted odds ratio, 4.44; 95% confidence interval, 1.55-12.69), which was found significant also after controlling for time-to-event, maternal age, gestational age at delivery, and offspring weight at birth. CONCLUSION Exposure to maternal gestational diabetes mellitus is an independent risk factor for long-term neuropsychiatric morbidity in the offspring.
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Affiliation(s)
- Kira Nahum Sacks
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michael Friger
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ilana Shoham-Vardi
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hanaa Abokaf
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Efrat Spiegel
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ruslan Sergienko
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Daniella Landau
- Department of Pediatrics, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Social patterning of overeating, binge eating, compensatory behaviours and symptoms of bulimia nervosa in young adult women: results from the Australian Longitudinal Study on Women's Health. Public Health Nutr 2016; 19:3158-3168. [PMID: 27329947 PMCID: PMC5217467 DOI: 10.1017/s1368980016001440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To study social patterning of overeating and symptoms of disordered eating in a general population. Design A representative, population-based cohort study. Setting The Australian Longitudinal Study on Women’s Health (ALSWH), Survey 1 in 1996 and Survey 2 in 2000. Subjects Women (n 12 599) aged 18–23 years completed a questionnaire survey at baseline, of whom 6866 could be studied prospectively. Results Seventeen per cent of women reported episodes of overeating, 16 % reported binge eating and 10 % reported compensatory behaviours. Almost 4 % of women reported symptoms consistent with bulimia nervosa. Low education, not living with family, perceived financial difficulty (OR=1·8 and 1·3 for women with severe and some financial difficulty, respectively, compared with none) and European language other than English spoken at home (OR=1·5 for European compared with Australian/English) were associated with higher prevalence of binge eating. Furthermore, longitudinal analyses indicated increased risk of persistent binge eating among women with a history of being overweight in childhood, those residing in metropolitan Australia, women with higher BMI, smokers and binge drinkers. Conclusions Overeating, binge eating and symptoms of bulimia nervosa are common among young Australian women and cluster with binge drinking. Perceived financial stress appears to increase the risk of binge eating and bulimia nervosa. It is unclear whether women of European origin and those with a history of childhood overweight carry higher risk of binge eating because of genetic or cultural reasons.
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Sundquist J, Ohlsson H, Winkleby MA, Sundquist K, Crump C. School Achievement and Risk of Eating Disorders in a Swedish National Cohort. J Am Acad Child Adolesc Psychiatry 2016; 55:41-46.e1. [PMID: 26703908 PMCID: PMC4691282 DOI: 10.1016/j.jaac.2015.09.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 09/19/2015] [Accepted: 10/08/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE High achievement in school has been associated with increased risk of eating disorders, including anorexia nervosa (AN) and bulimia nervosa (BN), but causality of these relationships is unclear. We sought to examine the association between school achievement and AN or BN in a national cohort and to determine the possible contribution of familial confounding using a co-relative design. METHOD This national cohort study involved 1,800,643 persons born in Sweden during 1972 to 1990 who were still living in Sweden at age 16 years and were followed up for AN and BN identified from inpatient and outpatient diagnoses through 2012. We used Cox regression to examine the association between school achievement and subsequent risk of AN or BN, and stratified Cox models to examine the gradient in this association across different strata of co-relative pairs (first cousins, half siblings, full siblings). RESULTS School achievement was positively associated with risk of AN among females and males (hazard ratio [HR] per additional 1 standard deviation, females: HR = 1.29; 95% CI = 1.25-1.33; males: HR = 1.29; 95% CI = 1.10-1.52), and risk of BN among females but not males (females: HR = 1.16; 95% CI = 1.11-1.20; males: HR = 1.05; 95% CI = 0.84-1.31). In co-relative analyses, as the degree of shared genetic and environmental factors increased (e.g., from first-cousin to full-sibling pairs), the association between school achievement and AN or BN substantially decreased. CONCLUSION In this large national cohort study, high achievement in school was associated with increased risk of AN and BN, but this appeared to be explained by unmeasured familial (genetic and environmental) factors.
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Affiliation(s)
- Jan Sundquist
- Lund University, Center for Primary Health Care Research, Malmö, Sweden
| | - Henrik Ohlsson
- Lund University, Center for Primary Health Care Research, Malmö, Sweden
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Su X, Xu B, Liang H, Olsen J, Yuan W, Cnattingius S, László KD, Li J. Prenatal maternal bereavement and risk of eating disorders in infants and toddlers: a population-based cohort study. BMC Psychiatry 2015; 15:229. [PMID: 26403981 PMCID: PMC4582887 DOI: 10.1186/s12888-015-0612-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 09/17/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Prenatal stress has been associated to a number of neuropsychiatric diseases but its role on the development of eating disorders (ED) remains unknown. Infants and toddlers with feeding or eating disorders are also at an increased risk of such diseases in later childhood and adolescence. We aimed to examine whether prenatal stress following maternal bereavement is associated with ED in infants and toddlers. METHODS This population-based cohort study included children born from 1977 to 2008 in Denmark (N = 2,127,126) and from 1977 to 2006 in Sweden (N = 2,974,908). Children were categorized as exposed if they were born to mothers who lost a close relative one year prior to or during pregnancy and were categorized as unexposed otherwise. They were followed until the age of 3 for a first diagnosis of ED. Poisson regression models were used to examine incidence rate ratio (IRR) between the exposed and the unexposed cohort. RESULTS A total of 9,403 ED cases were identified and 179 of whom were in the exposed cohort. Offspring born to mothers bereaved by loss of a core family member (older child or spouse) within the six months before pregnancy had a higher risk of ED than the unexposed offspring (IRR: 1.63, 95% confidence intervals (CI): 1.07-2.47). In stratified analyses, bereavement during the six months before pregnancy was associated with an increased risk of ED in boys (IRR: 2.21, 95% CI: 1.28-3.82), but not in girls (IRR: 1.18, 95% CI: 0.61-2.27). DISCUSSION This is the first population-based study to explore the association between prenatal stress and the risk of ED in infants and toddlers within two Nordic countries. This study added new evidence of early life stress for etiology of ED while the potential mechanism still needs further studies. CONCLUSIONS Prenatal stress following maternal bereavement by loss of a core family member is associated with an increased risk of ED among infants and toddlers. The six months before conception may be a susceptible time window, especially for boys.
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Affiliation(s)
- Xiujuan Su
- Department of Women's and Children's Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, PR China. .,Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, 8000, Denmark.
| | - Beibei Xu
- Medical Informatics Center, Peking University, Beijing, PR China.
| | - Hong Liang
- Department of Reproductive Epidemiology and Social Science, National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, 200032, PR China.
| | - Jørn Olsen
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, 8000, Denmark.
| | - Wei Yuan
- Department of Reproductive Epidemiology and Social Science, National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, 200032, PR China.
| | - Sven Cnattingius
- Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
| | - Krisztina D. László
- Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - Jiong Li
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, 8000, Denmark.
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Bould H, Sovio U, Koupil I, Dalman C, Micali N, Lewis G, Magnusson C. Do eating disorders in parents predict eating disorders in children? Evidence from a Swedish cohort. Acta Psychiatr Scand 2015; 132:51-9. [PMID: 25572654 DOI: 10.1111/acps.12389] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We investigated whether parental eating disorders (ED) predict ED in children, using a large multigeneration register-based sample. METHOD We used a subset of the Stockholm Youth Cohort born 1984-1995 and resident in Stockholm County in 2001-2007 (N = 286,232), The exposure was a diagnosed eating disorder in a parent; the outcome was any eating disorder diagnosis in their offspring, given by a specialist clinician, or inferred from an appointment at a specialist eating disorder clinic. A final study sample of 158,697 (55.4%) had data on these variables and confounding factors and contributed a total of 886,241 person years to the analysis. RESULTS We found good evidence in support of the hypothesis that ED in either parent are independently associated with ED in their female children (HR 1.97 (95% CI: 1.17-3.33), P = 0.01) and that ED in mothers are independently associated with ED in their female children (HR 2.35 (95% CI: 1.39-3.97) P = 0.001). Numbers were too low to permit separate analysis of ED in parents and their male children. CONCLUSION Eating disorders in parents were associated with ED in children. This study adds to our knowledge about the intergenerational transmission of ED, which will help identify high-risk groups and brings about the possibility of targeted prevention.
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Affiliation(s)
- H Bould
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - U Sovio
- Department of Obstetrics & Gynaecology, The Rosie Hospital, Cambridge, UK
| | - I Koupil
- Centre for Health Equity Studies, Stockholm University/Karolinska Institute, Stockholm, Sweden
| | - C Dalman
- Division of Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - N Micali
- Behavioural and Brain Sciences Unit, UCL Institute of Child Health, London, UK
| | - G Lewis
- Mental Health Sciences Unit, Faculty of Brain Sciences, UCL, London, UK
| | - C Magnusson
- Division of Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Tenconi E, Santonastaso P, Monaco F, Favaro A. Obstetric complications and eating disorders: a replication study. Int J Eat Disord 2015; 48:424-30. [PMID: 24862630 DOI: 10.1002/eat.22304] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 05/11/2014] [Accepted: 05/13/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To provide data about the role of obstetric complications (OCs) in a large and well-characterized sample of patients with anorexia nervosa (AN) or bulimia nervosa (BN). METHOD The new sample consists of 150 patients with AN and 35 patients with BN, and 73 healthy women; statistical analyses were performed on the new sample alone and on the larger sample created by merging the new dataset with the previous one (264 AN, 108 BN, and 624 healthy women). All data about OCs were collected blind to diagnostic status. RESULTS OC rates in the replication sample were similar to those of our previous studies. In the whole sample, the risk of developing AN was significantly associated with the occurrence and number of pregnancy, delivery, hypoxic, and dysmaturity complications. The risk of developing BN was significantly associated with dysmaturity complications. Signs of retarded fetal growth (being small and short for gestational age, short head circumference) significantly distinguished BN patients from both AN and healthy individuals. Significantly higher number of OCs were found in the binge eating/purging type of AN, in comparison with restricting AN patients. DISCUSSION Our study provides further evidence of the role of OCs as putative risk factors for the development of eating disorders, showing different pathways between AN and BN.
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Affiliation(s)
- Elena Tenconi
- Department of Neurosciences, University of Padova, Padova, Italy
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Bould H, Koupil I, Dalman C, DeStavola B, Lewis G, Magnusson C. Parental mental illness and eating disorders in offspring. Int J Eat Disord 2015; 48:383-91. [PMID: 24965548 DOI: 10.1002/eat.22325] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 05/27/2014] [Accepted: 06/14/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate which parental mental illnesses are associated with eating disorders in their offspring. METHOD We used data from a record-linkage cohort study of 158,679 children aged 12-24 years at the end of follow-up, resident in Stockholm County from 2001 to 2007, to investigate whether different parental mental illnesses are risk factors for eating disorders in their offspring. The outcome measure was diagnosis of any eating disorder, either from an ICD or DSM-IV code, or inferred from an appointment at a specialist eating disorder clinic. RESULTS Mental illness in parents is a risk factor for eating disorders in female offspring (Adjusted Hazard Ratio (AHR) 1.57 (95% CI 1.42, 1.92), p < 0.0001). Risk of eating disorders is increased if there is a parental diagnosis of bipolar affective disorder (AHR 2.28 (95% CI 1.39, 3.72), p = 0.004), personality disorder (AHR 1.57 (95% CI 1.01, 2.44), p = 0.043) or anxiety/depression (AHR 1.57 (95% CI 1.32, 1.86), p < 0.0001). There is a lack of statistical evidence for an association with parental schizophrenia (AHR 1.41 (95% CI 0.96, 2.07), p = 0.08), and somatoform disorder (AHR 1.25 (95% CI 0.74, 2.13), p = 0.40). There is no support for a relationship between parental substance misuse and eating disorders in children (AHR 1.08 (95% CI 0.82, 1.43), p = 0.57). DISCUSSION Parental mental illness, specifically parental anxiety, depression, bipolar affective disorder, and personality disorders, are risk factors for eating disorders in their offspring.
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Affiliation(s)
- Helen Bould
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
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Koch SV, Larsen JT, Mouridsen SE, Bentz M, Petersen L, Bulik C, Mortensen PB, Plessen KJ. Autism spectrum disorder in individuals with anorexia nervosa and in their first- and second-degree relatives: Danish nationwide register-based cohort-study. Br J Psychiatry 2015; 206:401-7. [PMID: 25657359 DOI: 10.1192/bjp.bp.114.153221] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/21/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Clinical and population-based studies report increased prevalence of autism spectrum disorders (ASD) in individuals with anorexia nervosa and in their relatives. No nationwide study has yet been published on co-occurrence of these disorders. AIMS To investigate comorbidity of ASD in individuals with anorexia nervosa, and aggregation of ASD and anorexia nervosa in their relatives. METHOD In Danish registers we identified all individuals born in 1981-2008, their parents, and full and half siblings, and linked them to data on hospital admissions for psychiatric disorders. RESULTS Risk of comorbidity of ASD in probands with anorexia nervosa and aggregation of ASD in families of anorexia nervosa probands were increased. However, the risk of comorbid and familial ASD did not differ significantly from comorbid and familial major depression or any psychiatric disorder in anorexia nervosa probands. CONCLUSIONS We confirm aggregation of ASD in probands with anorexia nervosa and in their relatives; however, the relationship between anorexia nervosa and ASD appears to be non-specific.
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Affiliation(s)
- Susanne V Koch
- Susanne V. Koch, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Janne T. Larsen, MSc, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Svend E. Mouridsen, MScPsych, Mette Bentz, MScPsych, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Denmark; Liselotte Petersen, MSc, PhD, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Cynthia Bulik, PhD, FAED, Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA, and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Preben B. Mortensen, MD, DMSci, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Kerstin J. Plessen, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Janne T Larsen
- Susanne V. Koch, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Janne T. Larsen, MSc, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Svend E. Mouridsen, MScPsych, Mette Bentz, MScPsych, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Denmark; Liselotte Petersen, MSc, PhD, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Cynthia Bulik, PhD, FAED, Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA, and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Preben B. Mortensen, MD, DMSci, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Kerstin J. Plessen, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Svend E Mouridsen
- Susanne V. Koch, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Janne T. Larsen, MSc, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Svend E. Mouridsen, MScPsych, Mette Bentz, MScPsych, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Denmark; Liselotte Petersen, MSc, PhD, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Cynthia Bulik, PhD, FAED, Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA, and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Preben B. Mortensen, MD, DMSci, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Kerstin J. Plessen, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Bentz
- Susanne V. Koch, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Janne T. Larsen, MSc, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Svend E. Mouridsen, MScPsych, Mette Bentz, MScPsych, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Denmark; Liselotte Petersen, MSc, PhD, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Cynthia Bulik, PhD, FAED, Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA, and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Preben B. Mortensen, MD, DMSci, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Kerstin J. Plessen, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Liselotte Petersen
- Susanne V. Koch, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Janne T. Larsen, MSc, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Svend E. Mouridsen, MScPsych, Mette Bentz, MScPsych, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Denmark; Liselotte Petersen, MSc, PhD, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Cynthia Bulik, PhD, FAED, Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA, and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Preben B. Mortensen, MD, DMSci, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Kerstin J. Plessen, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Cynthia Bulik
- Susanne V. Koch, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Janne T. Larsen, MSc, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Svend E. Mouridsen, MScPsych, Mette Bentz, MScPsych, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Denmark; Liselotte Petersen, MSc, PhD, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Cynthia Bulik, PhD, FAED, Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA, and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Preben B. Mortensen, MD, DMSci, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Kerstin J. Plessen, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Preben B Mortensen
- Susanne V. Koch, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Janne T. Larsen, MSc, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Svend E. Mouridsen, MScPsych, Mette Bentz, MScPsych, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Denmark; Liselotte Petersen, MSc, PhD, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Cynthia Bulik, PhD, FAED, Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA, and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Preben B. Mortensen, MD, DMSci, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Kerstin J. Plessen, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kerstin J Plessen
- Susanne V. Koch, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Janne T. Larsen, MSc, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Svend E. Mouridsen, MScPsych, Mette Bentz, MScPsych, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Denmark; Liselotte Petersen, MSc, PhD, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Cynthia Bulik, PhD, FAED, Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA, and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Preben B. Mortensen, MD, DMSci, National Center for Register-based Research, School of Business and Social Sciences, University of Aarhus, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Department of Biomedicine, Faculty of Health, Aarhus University, Denmark; Kerstin J. Plessen, MD, PhD, Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region and Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Lantzouni E, Cox MH, Salvator A, Crosby RD. Mother-Daughter Coping and Disordered Eating. EUROPEAN EATING DISORDERS REVIEW 2015; 23:126-32. [DOI: 10.1002/erv.2343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 12/18/2014] [Accepted: 12/21/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Eleni Lantzouni
- Department of Pediatrics; Children's Hospital Medical Center of Akron; Akron OH USA
- Department of Pediatrics; Children's Hospital of Philadelphia; Philadelphia PA USA
- Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
| | | | | | - Ross D. Crosby
- Neuropsychiatric Research Institute; Fargo ND USA
- School of Medicine and Health Sciences; University of North Dakota; Fargo ND USA
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Le Grange D, O'Connor M, Hughes EK, Macdonald J, Little K, Olsson CA. Developmental antecedents of abnormal eating attitudes and behaviors in adolescence. Int J Eat Disord 2014; 47:813-24. [PMID: 25046731 DOI: 10.1002/eat.22331] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study capitalizes on developmental data from an Australian population-based birth cohort to identify developmental markers of abnormal eating attitudes and behaviors in adolescence. The aims were twofold: (1) to develop a comprehensive path model identifying infant and childhood developmental correlates of Abnormal Eating Attitudes and Behaviors in adolescence, and (2) to explore potential gender differences. METHOD Data were drawn from a 30-year longitudinal study that has followed the health and development of a population based cohort across 15 waves of data collection from infancy since 1983: The Australian Temperament Project. Participants in this analysis were the 1,300 youth who completed the 11th survey at 15-16 years (1998) and who completed the eating disorder inventory at this time point. RESULTS Developmental correlates of Abnormal Eating Attitudes and Behaviors in mid-adolescence were temperamental persistence, early gestational age, persistent high weight, teen depression, stronger peer relationships, maternal dieting behavior, and pubertal timing. Overall, these factors accounted for 28% of the variance in Abnormal Eating Attitudes and Behaviors at 15-16 years of age. Depressive symptoms, maternal dieting behavior, and early puberty were more important factors for girls. Late puberty was a more important factor for boys. DISCUSSION Findings address an important gap in our understanding of the etiology of Abnormal Eating Attitudes and Behaviors in adolescence and suggest multiple targets for preventive intervention.
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Affiliation(s)
- Daniel Le Grange
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois
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Raevuori A, Linna MS, Keski-Rahkonen A. Prenatal and perinatal factors in eating disorders: a descriptive review. Int J Eat Disord 2014; 47:676-85. [PMID: 24946313 DOI: 10.1002/eat.22323] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 06/08/2014] [Accepted: 06/09/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this descriptive review is to summarize the current scientific evidence on various prenatal and perinatal exposures affecting later development of eating disorders among offspring. METHOD Studies were searched from PubMed database with the following keywords: eating disorders and disordered eating and anorexia nervosa and bulimia nervosa and binge eating disorder and prenatal exposure delayed effects and maternal exposure and perinatology. A comprehensive manual search, including search from the reference list of included articles, was also performed. RESULTS The attributable risk for prenatal and perinatal factors in anorexia nervosa (AN) is 3.6%. Numerous prenatal and perinatal factors have been associated with offspring AN, but only prematurity has been replicated in different samples. The risk of bulimia nervosa (BN) in offspring has attracted less study, and despite varying positive associations, there are no replicated findings. Higher prenatal testosterone may protect against the development of a range of disordered eating symptoms, although studies are not consistent. DISCUSSION Evidence in support of an effect of prenatal and perinatal factors on eating disorders or disordered eating in offspring is conflicting. If present, the overall effect appears to be relatively small, and it is likely that the early risk factors operate in conjunction with other biological, genetic, and/or environmental risk factors to bring on eating pathology. Genetically sensitive designs, such as sibling and twin studies, are needed to disentangle the different types of risk factors and ensure that prenatal/perinatal effects are "causal" rather than indications of genetic risk.
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Affiliation(s)
- Anu Raevuori
- Department of Public Health, Hjelt Institute, University of Helsinki, Finland; Child Psychiatry Research Center, Institute of Clinical Medicine, University of Turku, Turku, Finland; Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
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Goodman A, Heshmati A, Koupil I. Family history of education predicts eating disorders across multiple generations among 2 million Swedish males and females. PLoS One 2014; 9:e106475. [PMID: 25162402 PMCID: PMC4146600 DOI: 10.1371/journal.pone.0106475] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 08/07/2014] [Indexed: 11/22/2022] Open
Abstract
Purpose To investigate which facets of parent and grandparent socio-economic position (SEP) are associated with eating disorders (ED), and how this varies by ED subtype and over time. Methods Total-population cohort study of 1,040,165 females and 1,098,188 males born 1973–1998 in Sweden, and followed for inpatient or outpatient ED diagnoses until 2010. Proportional hazards models estimated associations with parental education, income and social class, and with grandparental education and income. Results 15,747 females and 1051 males in our sample received an ED diagnosis, with rates increasing in both sexes over time. ED incidence in females was independently predicted by greater educational level among the father, mother and maternal grandparents, but parent social class and parental income showed little or no independent effect. The associations with education were equally strong for anorexia nervosa, bulimia nervosa and ED not-otherwise-specified, and had increased over time. Among males, an apparently similar pattern was seen with respect to anorexia nervosa, but non-anorexia ED showed no association with parental education and an inverse association with parental income. Conclusions Family history of education predicts ED in gender- and disorder-specific ways, and in females the effect is observed across multiple generations. Particularly given that these effects may have grown stronger in more recent cohorts, these findings highlight the need for further research to clarify the underlying mechanisms and identify promising targets for prevention. Speculatively, one such mechanism may involve greater internal and external demands for academic success in highly educated families.
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Affiliation(s)
- Anna Goodman
- CHESS, Centre for Health Equity Studies, Karolinska Institutet, Stockholm University, Stockholm, Sweden
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Amy Heshmati
- CHESS, Centre for Health Equity Studies, Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - Ilona Koupil
- CHESS, Centre for Health Equity Studies, Karolinska Institutet, Stockholm University, Stockholm, Sweden
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Goodman A, Heshmati A, Malki N, Koupil I. Associations between birth characteristics and eating disorders across the life course: findings from 2 million males and females born in Sweden, 1975-1998. Am J Epidemiol 2014; 179:852-63. [PMID: 24553681 DOI: 10.1093/aje/kwt445] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Birth characteristics predict a range of major physical and mental disorders, but findings regarding eating disorders are inconsistent and inconclusive. This total-population Swedish cohort study identified 2,015,862 individuals born in 1975-1998 and followed them for anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified until the end of 2010. We examined associations with multiple family and birth characteristics and conducted within-family analyses to test for maternal-level confounding. In total, 1,019 males and 15,395 females received an eating disorder diagnosis. Anorexia nervosa was independently predicted by multiple birth (adjusted hazard ratio = 1.33, 95% confidence interval: 1.15, 1.53) for twins or triplets vs. singletons) and lower gestational age (adjusted hazard ratio = 0.96, 95% confidence interval: 0.95, 0.98) per extra week of gestation, with a clear dose-response pattern. Within-family analyses provided no evidence of residual maternal-level confounding. Higher birth weight for gestational age showed a strong, positive dose-response association with bulimia nervosa (adjusted hazard ratio = 1.15, 95% confidence interval: 1.09, 1.22, per each standard-deviation increase), again with no evidence of residual maternal-level confounding. We conclude that some perinatal characteristics may play causal, disease-specific roles in the development of eating disorders, including via perinatal variation within the normal range. Further research into the underlying mechanisms is warranted. Finally, several large population-based studies of anorexia nervosa have been conducted in twins; it is possible that these studies considerably overestimate prevalence.
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Ahrén JC, Chiesa F, Koupil I, Magnusson C, Dalman C, Goodman A. We are family--parents, siblings, and eating disorders in a prospective total-population study of 250,000 Swedish males and females. Int J Eat Disord 2013; 46:693-700. [PMID: 23740699 DOI: 10.1002/eat.22146] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2013] [Indexed: 11/11/2022]
Abstract
OBJECTIVE We examined how parental characteristics and other aspects of family background were associated with the development of eating disorders (ED) in males and females. METHOD We used register data and record linkage to create the prospective, total-population study the Stockholm Youth Cohort. This cohort comprises all children and adolescents who were ever residents in Stockholm County between 2001 and 2007, plus their parents and siblings. Individuals born between 1984 and 1995 (N = 249, 884) were followed up for ED from age 12 to end of 2007. We used Cox regression modeling to investigate how ED incidence was associated with family socioeconomic position, parental age, and family composition. RESULTS In total, 3,251 cases of ED (2,971 females; 280 males) were recorded. Higher parental education independently predicted a higher rate of ED in females [e.g., adjusted hazard ratio (HR) 1.69 (95% CI: 1.42, 2.02) for degree-level vs. elementary-level maternal education], but not in males [HR 0.73 (95% CI: 0.42, 1.28), p < 0.001 for gender interaction]. In females, an increasing number of full-siblings was associated with lower rate of ED [e.g., fully adjusted HR 0.92 (95% CI: 0.88, 0.97) per sibling], whereas an increasing number of half-siblings was associated with a higher rate [HR 1.05 (95% CI: 1.01, 1.09) per sibling]. DISCUSSION The effect of parental education on ED rate varies between males and females, whereas the effect of number of siblings varies according to whether they are full or half-siblings. A deeper understanding of these associations and their underlying mechanisms may provide etiological insights and inform the design of preventive interventions.
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Affiliation(s)
- Jennie C Ahrén
- CHESS (Centre for Health Equity Studies), Karolinska Institutet/Stockholm University, Stockholm, Sweden
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Hartmann AS, Greenberg JL, Wilhelm S. The relationship between anorexia nervosa and body dysmorphic disorder. Clin Psychol Rev 2013; 33:675-85. [PMID: 23685673 DOI: 10.1016/j.cpr.2013.04.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Revised: 04/10/2013] [Accepted: 04/10/2013] [Indexed: 12/27/2022]
Abstract
Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are severe body image disorders that highly impair individuals in their daily functioning. They are discrete but overlapping nosological entities. In this review, we examine similarities between AN and BDD with regard to clinical, personality and demographic aspects, such as comorbidity, phenomenology, and treatment outcome. The review suggests that the two disorders are highly comorbid, and show similar ages of onset, illness trajectories, and comparable clinical and personality characteristics. However, important differences emerge in their responsiveness to psychosocial and psychopharmacological treatment, which are discussed. Clinical implications of these findings are summarized and directions for future research are delineated, with a focus on how current treatment components from each disorder may inform new interventions for both disorders.
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Park JY, Baek SY, Kim HS, Lim JH, Kim TH. Testing the Biobehavioral Family Model in Understanding the Eating Problems of Adolescent Girls. CHILD HEALTH NURSING RESEARCH 2013. [DOI: 10.4094/chnr.2013.19.3.228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Su-Yon Baek
- College of Nursing, Yonsei University, Seoul, Korea
| | - Hee-Soon Kim
- College of Nursing·Nursing Policy Research Institute, Yonsei University, Seoul, Korea
| | - Jung-Ha Lim
- Department of Home Economics Education, College of Education, Korea University, Seoul, Korea
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Krug I, Taborelli E, Sallis H, Treasure J, Micali N. A systematic review of obstetric complications as risk factors for eating disorder and a meta-analysis of delivery method and prematurity. Physiol Behav 2012. [PMID: 23178235 DOI: 10.1016/j.physbeh.2012.11.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The aim of this study was to systematically review the literature on obstetric factors at birth and their role as risk factors for a subsequent eating disorder (ED) and where possible to perform a meta-analysis of case-control studies of EDs and obstetric complications (OCs). METHOD Studies were ascertained by computer searches of electronic databases (Medline, PsycINFO, Web of Science and CINAHL), searches of reference lists and from raw data obtained upon request from the authors. A total of 14 studies were identified for the systematic review, of which 6 were eligible for the subsequent meta-analysis. Of the selected 6 studies, 5 reported on the same OCs, namely vaginal instrumental delivery and prematurity. Accordingly, meta-analyses were run on these two variables. Both analyses were conducted on anorexia nervosa (AN) patients. RESULTS Findings from the systematic review were conflicting, with some studies reporting a significant relationship between OCs and ED diagnoses and/or ED symptomatology and others refuting it. A non-significant association of instrumental delivery [pooled odds ratio (OR) 1.06, 95%CI: 0.69, 1.65] and prematurity [pooled OR 1.17, 95%CI: 0.91, 1.52] with AN was revealed in our meta-analysis. CONCLUSION The current literature on OCs as risk factors for a later ED is contradictory. The range of different occurrences considered as OCs and methodological limitations hinder ultimate conclusions. Upcoming studies should pool datasets together to obtain sufficient power to assess OCs and EDs in combination.
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Affiliation(s)
- Isabel Krug
- Eating Disorders Unit of Psychological Medicine, Institute of Psychiatry, King's College London, De Crespigny Park, UK.
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Treasure J, Corfield F, Cardi V. A three-phase model of the social emotional functioning in eating disorders. EUROPEAN EATING DISORDERS REVIEW 2012; 20:431-8. [PMID: 22539368 DOI: 10.1002/erv.2181] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Problems with social emotional functioning are an important part of eating disorder psychopathology. AIM This study aimed to propose a model of social emotional functioning before and during the illness and to explain the consequences for those involved. METHOD We propose a three-phase model of social and emotional processes as both causal and maintaining factors in anorexia nervosa. The predictions from this model are examined, and we consider the relevance for treatment. RESULTS The evidence base for the theoretical model is presented: Phase 1 describes causal predispositions and environments, Phase 2 notes the way in which the symptoms themselves impact on brain function and social cognition and Phase 3 explains the reactions of close others. CONCLUSIONS A three-phase model including interpersonal and socio-emotional elements can be used to shape and plan treatment interventions. Understanding causal chains and consequences can give a rationale for change and frame therapeutic interventions.
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Affiliation(s)
- Janet Treasure
- Eating Disorders Unit, Institute of Psychiatry, London, UK.
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Ahrén JC, Chiesa F, Af Klinteberg B, Koupil I. Psychosocial determinants and family background in anorexia nervosa--results from the Stockholm Birth Cohort Study. Int J Eat Disord 2012; 45:362-9. [PMID: 21805483 DOI: 10.1002/eat.20953] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2011] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of this study was to examine the associations between psychosocial factors and family background and incidence of anorexia nervosa (AN) in a Swedish cohort. METHOD The Stockholm Birth Cohort, SBC (N = 14,294) contains information on social background and general health in males and females, born in Stockholm 1953. Hospitalizations for AN, based on diagnoses from the ICD-8 through ICD-10, were recorded from 1969 to 2002. Cox proportional hazard regression was used to measure the association between psychosocial characteristics and family background and the risk of AN. RESULTS Higher maternal education was associated with a higher risk for hospitalization for AN. An increased risk for AN was also found among females who stated that they "often compare their future prospects with others." DISCUSSION Although the study is based on a low number of cases, it confirms earlier findings of higher maternal education among individuals with eating disorders in similar cohorts.
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Affiliation(s)
- Jennie C Ahrén
- Centre for Health Equity Studies-CHESS, Karolinska Institutet, Stockholm University, Stockholm, Sweden.
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Biologically based restorative management of tooth wear. Int J Dent 2012; 2012:742509. [PMID: 22315608 PMCID: PMC3272350 DOI: 10.1155/2012/742509] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Revised: 09/20/2011] [Accepted: 09/20/2011] [Indexed: 11/18/2022] Open
Abstract
The prevalence and severity of tooth wear is increasing in industrialised nations. Yet, there is no high-level evidence to support or refute any therapeutic intervention. In the absence of such evidence, many currently prevailing management strategies for tooth wear may be failing in their duty of care to first and foremost improve the oral health of patients with this disease. This paper promotes biologically sound approaches to the management of tooth wear on the basis of current best evidence of the aetiology and clinical features of this disease. The relative risks and benefits of the varying approaches to managing tooth wear are discussed with reference to long-term follow-up studies. Using reference to ethical standards such as “The Daughter Test”, this paper presents case reports of patients with moderate-to-severe levels of tooth wear managed in line with these biologically sound principles.
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Perinatal complications in unaffected sisters of anorexia nervosa patients: testing a covariation model between genetic and environmental factors. Eur Arch Psychiatry Clin Neurosci 2011; 261:391-6. [PMID: 21193995 DOI: 10.1007/s00406-010-0181-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2010] [Accepted: 12/15/2010] [Indexed: 10/18/2022]
Abstract
Although perinatal complications are hypothesized to be risk factors for the development of anorexia nervosa (AN), no study to date explored this issue using a discordant sibling design. This type of design allows to explore whether the risk for obstetric complications is itself a consequence of the genetic vulnerability for AN (covariation model) or whether obstetric complications increase the risk of AN independently of (additive model), or in interaction with (interaction model), the disorder's genetic liability. The presence of perinatal complications was assessed through review of the obstetric records of 60 AN subjects, 60 unaffected sisters, and 70 healthy subjects. Unaffected sisters and healthy controls were compared in relation to perinatal characteristics and complications. There was no evidence for an elevated rate of complications in unaffected siblings of AN patients. Mothers with a positive psychiatric history tended to have more perinatal complications. Perinatal complications seem to be independent risk factors that may interact with, but are not caused by, familial risk factors for AN. In terms of prevention, a particular attention should be paid to mothers with a lifetime history of psychiatric disorders.
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Austin SB. The blind spot in the drive for childhood obesity prevention: bringing eating disorders prevention into focus as a public health priority. Am J Public Health 2011; 101:e1-4. [PMID: 21493926 DOI: 10.2105/ajph.2011.300182] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Public health attention to childhood obesity has increased in tandem with the growing epidemic, but despite this intense focus, successes in prevention have lagged far behind. There is a blind spot in our drive for childhood obesity prevention that prevents us from generating sufficiently broad solutions. Eating disorders and the constellation of perilous weight-control behaviors are in that blind spot. Evidence is mounting that obesity and eating disorders are linked in myriad ways, but entrenched myths about eating disorders undermine our ability to see the full range of leverage points to target in obesity preventive intervention studies. Our efforts to prevent childhood obesity can no longer afford to ignore eating disorders and the assemblage of related behaviors that persist unabated.
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Affiliation(s)
- S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Children's Hospital Boston, Boston, MA 02115, USA.
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Wehkalampi K, Hovi P, Strang-Karlsson S, Räikkönen K, Pesonen AK, Heinonen K, Mäkitie O, Järvenpää AL, Eriksson JG, Andersson S, Kajantie E. Reduced body size and shape-related symptoms in young adults born preterm with very low birth weight: Helsinki study of very low birth weight adults. J Pediatr 2010; 157:421-7, 427.e1. [PMID: 20400106 DOI: 10.1016/j.jpeds.2010.02.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 01/20/2010] [Accepted: 02/23/2010] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To test the hypothesis that being born prematurely with very low birth weight (VLBW) (birth weight<or=1500 g) is associated with subphenotypes of eating disorders (dissatisfaction with body shape and pursuit of thinness) in young adulthood. STUDY DESIGN Preterm-born VLBW subjects (n=163) and controls (n=189) born at term completed 3 subscales of Eating Disorder Inventory-2 questionnaire (EDI): Drive for Thinness, Body Dissatisfaction, and Bulimia. Data were analyzed with multiple linear regression adjusted for confounders. RESULTS Among both sexes, EDI total scores were lower in VLBW subjects than in controls. The fully adjusted difference was -11.0% (95% CI, -18.4%, -2.2%) for women and -11.2% (95% CI, -20.2%, -1.3%) for men. Among women the lower scores in VLBW adults were observed in each EDI subscale. Results were similar when adjusted also for fat percentage, measured by dual-energy x-ray absorptiometry. Of the covariates, higher body mass index and higher score in Beck Depression Inventory contributed significantly to a higher EDI total score. CONCLUSIONS Young adults, particularly women, born prematurely with VLBW have fewer body size and shape-related symptoms and possibly lower risk for eating disorders than their term-born peers.
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Affiliation(s)
- Karoliina Wehkalampi
- Department of Health Promotion and Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
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Bilali A, Galanis P, Velonakis E, Katostaras T. Factors associated with abnormal eating attitudes among Greek adolescents. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2010; 42:292-298. [PMID: 20591741 DOI: 10.1016/j.jneb.2009.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2008] [Revised: 06/03/2009] [Accepted: 06/04/2009] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To estimate the prevalence of abnormal eating attitudes among Greek adolescents and identify possible risk factors associated with these attitudes. DESIGN Cross-sectional, school-based study. SETTING Six randomly selected schools in Patras, southern Greece. PARTICIPANTS The study population consisted of 540 Greek students aged 13-18 years, and the response rate was 97%. MAIN OUTCOME MEASURE The dependent variable was scores on the Eating Attitudes Test-26, with scores > or = 20 indicating abnormal eating attitudes. ANALYSIS Bivariate analysis included independent Student t test, chi-square test, and Fisher's exact test. Multivariate logistic regression analysis was applied for the identification of the predictive factors, which were associated independently with abnormal eating attitudes. A 2-sided P value of less than .05 was considered statistically significant. RESULTS The prevalence of abnormal eating attitudes was 16.7%. Multivariate logistic regression analysis demonstrated that females, urban residents, and those with a body mass index outside normal range, a perception of being overweight, body dissatisfaction, and a family member on a diet were independently related to abnormal eating attitudes. CONCLUSIONS AND IMPLICATIONS The results indicate that a proportion of Greek adolescents report abnormal eating attitudes and suggest that multiple factors contribute to the development of these attitudes. These findings are useful for further research into this topic and would be valuable in designing preventive interventions.
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Affiliation(s)
- Aggeliki Bilali
- Laboratory of Demography, Faculty of Nursing, University of Athens, Athens, Greece
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