Eating disorders and antecedent anxiety disorders: a controlled study

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioral Science

Background:

• Anxiety disorders are common comorbidities in eating disorders.
• The temporal relationship between anxiety disorders and eating disorders requires further investigation to establish causality.

Purpose of the Study:

• To determine if antecedent anxiety disorders are plausible risk factors for anorexia nervosa (AN) and bulimia nervosa (BN).
• To compare the prevalence and age of onset of anxiety disorders in women with AN, BN, major depression (MD), and randomly selected controls (RC).

Main Methods:

• A comparative study involving 68 women with AN, 116 with BN, 56 with MD, and 98 RC.
• Analysis of the prevalence and age of onset of adult and childhood anxiety disorders relative to the primary diagnosis.
• Multivariate logistic regressions were used to calculate odds ratios (ORs) for specific anxiety disorders.

Main Results:

• Comorbid anxiety disorders were prevalent across all clinical groups (AN: 60%, BN: 57%, MD: 48%).
• Anxiety disorders preceded the primary diagnosis in a majority of AN (90%), BN (94%), and MD (71%) patients.
• Overanxious disorder and obsessive-compulsive disorder showed significantly elevated ORs for AN; overanxious disorder and social phobia for BN and MD.

Conclusions:

• Certain anxiety disorders serve as non-specific risk factors for subsequent affective and eating disorders.
• Specific anxiety disorders may represent more targeted antecedent risk factors for AN and BN.
• The findings support the role of antecedent anxiety in the etiology of eating disorders.