Association of Genetic and Phenotypic Assessments With Onset of Disordered Eating Behaviors and Comorbid Mental Health Problems Among Adolescents

Lauren Robinson (1) , Zuo Zhang (1) , Tianye Jia (2, 1) , Marina Bobou (3) , Anna Roach (3) , Iain Campbell (1) , Madeleine Irish (1) , Erin Burke Quinlan (3) , Nicole Tay (3) , Edward Barker (3) , Tobias Banaschewski (4) , Arun Bokde (5) , Antoine Grigis (6) , Hugh Garavan (7) , Andreas Heinz (8) , Bernd Ittermann (9) , Jean-Luc Martinot (10, 11) , Argyris Stringaris (12) , Jani Penttilä , Betteke van Noort , Yvonne Grimmer , Marie-Laure Paillère Martinot (10, 11) , Corinna Insensee , Andreas Becker , Frauke Nees , Dimitri Papadopoulos Orfanos (6) , Tomáš Paus , Luise Poustka , Sarah Hohmann , Juliane Fröhner (13) , Michael Smolka , Henrik Walter , Robert Whelan (5) , Gunter Schumann , Ulrike Schmidt , Sylvane Desrivières

1 King‘s College London
2 Fudan University [Shanghai]
3 Institute of Psychiatry, Psychology & Neuroscience, King's College London
4 Universität Heidelberg [Heidelberg] = Heidelberg University
5 Trinity College Dublin
6 NEUROSPIN - Service NEUROSPIN
7 University of Vermont [Burlington]
8 Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]
9 PTB - Physikalisch-Technische Bundesanstalt [Berlin]
10 CB - CB - Centre Borelli - UMR 9010
11 ERL Inserm U1299 - Trajectoires développementales en psychiatrie : mesures et modélisations
12 CNRM - Center for Neuroscience and Regenerative Medicine [Bethesda]
13 TU Dresden - Technische Universität Dresden = Dresden University of Technology

Importance Eating disorders are serious mental disorders with increasing prevalence. Without early identification and treatment, eating disorders may run a long-term course. Objective To characterize any associations among disordered eating behaviors (DEBs) and other mental health disorders and to identify early associations with the development of symptoms over time. Design, Setting, and Participants This multicenter, population-based, longitudinal cohort study used data from baseline (collected in 2010), follow-up 1 (collected in 2012), and follow-up 2 (collected in 2015) of the IMAGEN Study, which included adolescents recruited from 8 European sites. The present study assessed data from 1623 healthy adolescents, aged 14 years at baseline, recruited from high schools. Data analyses were performed from January 2018 to September 2019. Main Outcomes and Measures Body mass index (BMI), mental health symptoms, substance use behaviors, and personality variables were investigated as time-varying associations of DEBs (dieting, binge eating, and purging) or change in BMI over time. Polygenic risk scores were calculated to investigate genetic contributions associated with BMI, attention-deficit/hyperactivity disorder (ADHD) and neuroticism to DEBs. Results In this cohort study of 1623 adolescents (829 girls [51.1%]) recruited at a mean (SD) age of 14.5 (0.4) years and followed up at ages 16 and 19 years, 278 adolescents (17.1%) reported binge eating, 334 adolescents (20.6%) reported purging, and 356 adolescents (21.9%) reported dieting at 14, 16, or 19 years. Among the precursors of DEBs, high BMI was associated with future dieting (OR, 3.44; 95% CI, 2.09-5.65). High levels of neuroticism (OR, 1.04; 95% CI, 1.01-1.06), conduct problems (OR, 1.41; 95% CI, 1.17-1.69), and deliberate self-harm (OR, 2.18; 95% CI, 1.37-3.45) were associated with future binge eating. Low agreeableness (OR, 0.95; 95% CI, 0.92-0.97), deliberate self-harm (OR, 2.59; 95% CI, 1.69-3.95), conduct problems (OR, 1.42; 95% CI, 1.20-1.68), alcohol misuse (OR, 1.31; 95% CI, 1.10-1.54), and drug abuse (OR, 2.91; 95% CI, 1.78-4.74) were associated with future purging. Polygenetic risk scores for BMI were associated with dieting (at 14 years: OR, 1.27; lower bound 95% CI, 1.08; at 16 years: OR, 1.38; lower bound 95% CI, 1.17); ADHD, with purging (at 16 years: OR, 1.25; lower bound 95% CI, 1.08; at 19 years, OR, 1.23; lower bound 95% CI, 1.06); and neuroticism, with binge eating (at 14 years: OR, 1.32; lower bound 95% CI, 1.11; at 16 years: OR, 1.24; lower bound 95% CI, 1.06), highlighting distinct etiologic overlaps between these traits. The DEBs predated other mental health problems, with dieting at 14 years associated with future symptoms of depression (OR, 2.53; 95% CI, 1.56-4.10), generalized anxiety (OR, 2.27; 95% CI, 1.14-4.51), deliberate self-harm (OR, 2.10; 95% CI, 1.51-4.24), emotional problems (OR, 1.24; 95% CI, 1.08-1.43), and smoking (OR, 2.16; 95% CI, 1.36-3.48). Purging at 14 years was also associated with future depression (OR, 2.87; 95% CI, 1.69-5.01) and anxiety (OR, 2.48; 95% CI, 1.49-4.12) symptoms. Conclusions and Relevance The findings of this study delineate temporal associations and shared etiologies among DEBs and other mental health disorders and emphasize the potential of genetic and phenotypical assessments of obesity, behavioral disorders, and neuroticism to improve early and differential diagnosis of eating disorders.

Domaines: Sciences du Vivant [q-bio]

Lauren Robinson, Zuo Zhang, Tianye Jia, Marina Bobou, Anna Roach, et al.. Association of Genetic and Phenotypic Assessments With Onset of Disordered Eating Behaviors and Comorbid Mental Health Problems Among Adolescents. JAMA Network Open, 2020, 3 (12), pp.e2026874. ⟨10.1001/jamanetworkopen.2020.26874⟩. ⟨hal-04551797⟩