Prior eating disorders linked to long-term depression risk for mothers

May 13, 2019

Science Daily/University College London

A history of eating disorders and body image concerns before or during pregnancy are associated with future depressive symptoms among mothers, finds a new UCL-led study published in the British Journal of Psychiatry.

"We found that women who have had an eating disorder at any point before childbirth, even if it was years earlier in adolescence, were more likely to experience depressive symptoms during pregnancy and up to 18 years after the birth of their child," said the study's lead author Dr Francesca Solmi (UCL Psychiatry).

"This finding suggests that many people with eating disorders might not fully recover since we know that eating disorders and depression often happen at the same time."

The researchers used data from the 'Children of the 90s' cohort study, including 9,276 women.

Previous studies had suggested that depressive symptoms among mothers with eating disorders might improve after the perinatal period, but those studies didn't have such a long follow-up time to confirm that the increased risk of depressive symptoms does in fact persist for women who have had an eating disorder.

The research team found that women who had ever had anorexia nervosa or bulimia nervosa experienced more depressive symptoms over an 18-year follow-up than those who had never had an eating disorder.

"Depressive symptoms in mothers have been shown to be associated with a number of negative outcomes for their children, such as emotional and behavioural problems. It is therefore important, to identify and treat eating disorders early, as these could be one potential cause of the depressive symptoms," said Dr Solmi.

"We should also identify pregnant women with an eating disorder, so that they can be provided with mental health support. This could benefit both mother and child in the long run."

Dr Abigail Easter, one of the authors of the paper who has developed training materials to help identify eating disorders in pregnancy, added: "There is a need for more training for practitioners and midwives on how to recognise eating disorders in pregnancy, which could help to reduce the long-term impact of mental ill-health."

Current guidelines from the National Institute for Health and Care Excellence (NICE) recommend that health care professionals use a questionnaire to identify depressive symptoms in pregnant women. The current study supports the value of this, as well as for identifying eating disorders.

"There's a lot of stigma around both depression and eating disorders, so many people might not feel comfortable talking about it or seeking help. Assessment of mental illness in pregnancy, as standard practice, could help health professionals pick up on signs of depression and/or eating disorders at this crucial stage of life," said first author Yu Wei Chua, who began the study at UCL before moving over to the University of Strathclyde.

The study was conducted by researchers at UCL, University of Strathclyde and King's College London, and was funded by Wellcome and the National Institute for Health Research UCLH Biomedical Research Centre.

https://www.sciencedaily.com/releases/2019/05/190513212359.htm

Persistent low body weight in young kids increases risk for anorexia nervosa later

January 31, 2019

Science Daily/University of North Carolina Health Care

A new study has found that a persistent low body mass index (BMI) in children, starting as young as age 2 for boys and 4 for girls, may be a risk factor for the development of anorexia nervosa in adolescence.

In addition, the study, published in the February 2019 issue of the Journal of the American Academy of Child and Adolescent Psychiatry, found that a persistent high BMI in childhood may be a risk factor for later development of bulimia nervosa, binge-eating disorder, and purging disorder. This large population study is based on analysis of data from 1,502 individuals who participated in the Avon Longitudinal Study of Parents and Children in the UK.

"Until now, we have had very little guidance on how to identify children who might be at increased risk for developing eating disorders later in adolescence," said Zeynep Yilmaz, PhD, study first author and an assistant professor of psychiatry and genetics at the UNC Center of Excellence for Eating Disorders in the University of North Carolina School of Medicine. "By looking at growth records of thousands of children across time, we saw early warning profiles that could signal children at risk."

Co-author Cynthia Bulik, PhD, Distinguished Professor of Eating Disorders also from UNC highlights, "Clinically, this means that pediatricians should be alert for children who fall off and stay below the growth curve throughout childhood. This could be an early warning sign of risk for anorexia nervosa. The same holds for children who exceed and remain above the growth curve -- only their risk is increased for the other eating disorders such as bulimia nervosa and binge-eating disorder."

Yilmaz said that although eating disorders are psychiatric in nature, the study highlights the need to also consider metabolic risk factors alongside psychological, sociocultural, and environmental components. "The differences in childhood body weight of adolescents who later developed eating disorders started to emerge at a very early age -- way too early to be caused by social pressures to be thin or dieting. A more likely explanation is that underlying metabolic factors that are driven by genetics, could predispose these individuals to weight dysregulation. This aligns with our other genetic work that has highlighted a metabolic component to anorexia nervosa."

Corresponding author of the study is Nadia Micali, MD, MRCPsych PhD, Full Professor at University of Geneva Faculty of Medicine and Head of Geneva University Hospitals' Division of Child and Adolescent Psychiatry.

"Our results also highlight the multi-factorial composition of eating disorders, as well as the need to develop early detection tools that could be used as part of routine checks by all pediatricians. Indeed, the earlier the problem is identified, the better it can be managed, especially if support is provided to the family as a whole, rather than just the individual," Micali said.

https://www.sciencedaily.com/releases/2019/01/190131143436.htm