Psychiatric Morbidity Is Overrepresented in Young Girls at High Risk of Developing Anorexia Nervosa

Psychiatric comorbidity frequently presents in anorexia nervosa (AN). Yet, the premorbid mental health status is relatively unknown. The aim of this study was to map out psychiatric morbidity and psychopathology among girls at familial high risk (FHR) of developing AN, thereby detecting possible underlying vulnerabilities preceding the disease.

Twenty-eight daughters of mothers with a history of AN (FHR daughters), aged 6-12, along with 42 comparison daughters without FHR for AN (COMP daughters), were recruited. The mothers completed a battery of parental diagnostic interviews and screening questionnaires regarding psychiatric diagnoses and psychological traits in their daughters, including the Development and Well-Being Assessment (DAWBA) and the Strengths and Difficulties Questionnaire (SDQ).

In comparison to the COMP daughters, the FHR daughters had 27 percentage points higher absolute risk of meeting criteria for ≥ 1 psychiatric diagnoses (32.1% versus 4.8%; unadjusted p = 0.007; adjusted p = 0.035), and 21 percentage points higher risk of ≥ 2 psychiatric diagnoses (unadjusted p = 0.007; adjusted p = 0.035) according to the DAWBA and/or as established by the Child and Adolescent Psychiatry clinics. Among the FHR daughters, anxiety disorders and autism were the most common diagnoses. In addition, the FHR daughters scored significantly higher on the Emotional symptoms subscale of the SDQ (p = 0.03).

Increased risks of psychiatric diagnoses and elevated emotional problems were found among girls at FHR for AN. The results may therefore suggest psychiatric morbidity to be a potential risk factor for developing AN.