Associations between adverse childhood experiences and clinical characteristics of eating disorders.
Patients with eating disorders (EDs) frequently report a history of childhood trauma (CT). We investigated whether certain subtypes of CT are associated with more severe features of EDs, independently of psychiatric comorbidity, and whether they act additively. One hundred and ninety-two patients with DSM-V-defined EDs were consecutively recruited. Five clinical characteristics were assessed: restraint, eating, shape and weight concerns on the EDE-Q, and daily functioning. CT was assessed by the childhood traumatism questionnaire. The clinical features were associated with at least one CT subtype (emotional, sexual or physical abuse, emotional neglect). Multivariate analyses adjusted for lifetime comorbid psychiatric disorders revealed that emotional abuse independently predicted higher eating, shape and weight concerns and lower daily functioning, whereas sexual and physical abuse independently predicted higher eating concern. A dose-effect relationship characterised the number of CT subtypes and the severity of the clinical features, suggesting a consistent and partly independent association between CT and more severe clinical and functional characteristics in EDs. Emotional abuse seems to have the most specific impact on ED symptoms. Last, not all CT subtypes have the same impact but they do act additively.
Department of Psychiatric Emergency &Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France.|Inserm, U1061, University of Montpellier, Montpellier, France.
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Guillaume
Inserm, U1061, University of Montpellier, Montpellier, France.
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Jaussent
Département de Médecine Nucléaire, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France.|Physiologie et Médecine Expérimentale du Cœur et des Muscles, INSERM U1046, UMR9214 CNRS, Université de Montpellier, France.
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Maimoun
Department of Psychiatric Emergency &Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France.
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Ryst
Department of Psychiatric Emergency &Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France.|Inserm, U1061, University of Montpellier, Montpellier, France.
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Seneque
Department of Psychiatric Emergency &Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France.
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Villain
Direction de la Recherche et de l'Innovation, CHRU Montpellier, Montpellier, France.
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Hamroun
Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France.
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Lefebvre
Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France.|INSERM Clinical Investigation Centre 1411, Montpellier, France.|Institute of Functional Genomics, CNRS UMR 5203/INSERM U1191, University of Montpellier, Montpellier, France.
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Renard
Department of Psychiatric Emergency &Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France.|Inserm, U1061, University of Montpellier, Montpellier, France.
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Courtet
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002650:Child Abuse, Sexual; D003710:Demography; D004644:Emotions; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000066550:Physical Abuse; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult