title: Clustering of eating disorder symptoms in a general population female twin sample: a latent class analysis.
abstract: BACKGROUND
  Previous studies have reported that the current DSM-IV eating disorder (ED) criteria do not adequately describe ED symptomatology. The objective of the current study was to examine the clustering of ED symptoms in a general population sample using latent class analysis (LCA).
  
  
  METHODS
  ED symptoms from 3723 female young adult twins (mean age 22) were analyzed using LCA, and resulting classes were compared on external validators reflecting ED and other co-morbid psychiatric diagnoses, substance use disorders (SUDs), and suicidality.
  
  
  RESULTS
  The optimal solution consisted of five latent classes characterized as: (1) Unaffected; (2) Low Weight Gain; (3) Weight Concerned; (4) Dieters; and (5) ED. Members of the ED class had significantly higher prevalence of co-morbid psychiatric disorders, SUDs, and suicidality than the Unaffected and Low Weight Gain classes, and elevated rates of suicidality and major depression compared to the Weight Concerned and Dieter classes, which differed from each other primarily in terms of current body mass index (BMI). Dieter class members were more likely to be overweight and obese and less likely to be underweight than Weight Concerned class members. The majority of women with an ED diagnosis were assigned to the ED class, and few differences were found between ED class members with and without an ED diagnosis.
  
  
  CONCLUSIONS
  The results add to the evidence that many women with significant ED psychopathology are not being identified by the DSM-IV ED categories.
authors.affiliation: Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St Louis, MO 63110, USA. duncana@psychiatry.wustl.edu
authors.forename: Alexis E
authors.initials: AE
authors.lastname: Duncan
authors.forename: Kathleen Keenan
authors.initials: KK
authors.lastname: Bucholz
authors.forename: Rosalind J
authors.initials: RJ
authors.lastname: Neuman
authors.forename: Arpana
authors.initials: A
authors.lastname: Agrawal
authors.forename: Pamela A F
authors.initials: PA
authors.lastname: Madden
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Heath
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D016000:Cluster Analysis; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004038:Diet, Reducing; D004200:Diseases in Twins / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D008923:Missouri; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D013405:Suicide / Q000523:psychology; D013851:Thinness