The association of anxiety disorders and obsessive compulsive personality disorder with anorexia nervosa: Evidence from a family study with discussion of nosological and neurodevelopmental implications

Abstract

Background: To investigate the association of anorexia nervosa with anxiety disorders through use of a case-control family study design.Method: Lifetime prevalence of anxiety disorders and obsessive compulsive personality disorder was determined among 574 first-degree relatives of 152 probands with anorexia nervosa and compared to rates observed among 647 first-degree relatives of 181 never-ill control probands.Results: Adjusting for comorbidity of the same illness in the proband, relatives of probands with anorexia nervosa, had a significantly higher prevalence of generalized anxiety, obsessive compulsive disorder, separation anxiety disorder, social phobia, panic disorder, and obsessive compulsive personality disorder compared to relatives of never-ill control probands.Conclusion: Anorexia nervosa may share familial liability factors in common with various anxiety phenotypes. In suggesting that a transmitted propensity for anxiety is a key aspect of vulnerability in anorexia nervosa, the findings point to research developments in the affective neurosciences, specifically the neurocircuitry of fear and anxiety, as a heuristic framework in which to interpret aspects of premorbid temperamental anxieties and clinical symptoms. V V C 2007 by Wiley Periodicals, Inc.

Personality and eating and weight disorders: an open research challenge

“…It is widely accepted that EWDs have a complex pathogenesis involving transactions among sociocultural, psychological, and neurobiological influences [4,9,[25][26][27][28][29]. However, these transactions have received limited research attention, although several hypotheses have been advanced in the literature.…”

“…For instance, Kaye and colleagues [26] argued that specific neurobiological factors, linked to specific childhood temperament and personality traits (i.e., anxiety, obsessions, and inflexibility), may create a vulnerability to developing AN. According to other scholars, AN patients seem to share familial liability factors, such as a trans-generational tendency for anxiety and specific personality features, which may be linked to fear and anxiety neuro-circuitry alterations and a familial vulnerability for AN [28]. Promising multivariate aetiological and maintenance models attempting to explain how certain personality traits work with other vulnerability factors to promote or maintain EWDs also provide valuable insights into the multi-factor nature of these clinical conditions [30].…”

Epidemiology of eating disorders part III: social epidemiology and case definitions revisited

“…Comorbidity studies and family studies indicate that eating disorder patients' family history of both anxiety and mood disorders (Gershon et al, 1984;Hudson et al, 1983a;Logue et al, 1989;Rivinus et al, 1984;Strober, Freeman, Lampert & Diamond, 2007;Strober et al, 1990). Twin studies of adult populations support a substantial shared genetic etiology between depression and generalized anxiety disorder (Jardine et al, 1984;Kendler, 1996;Kendler et al, 1992;Roy et al, 1995), between eating disorders and major depression Walters et al, 1992), and between eating disorders and anxiety disorders .…”

Genetic epidemiology of eating disorders and co-occurring conditions: The role of endophenotypes

“…Examples of candidate endophenotypes are temperaments such as perfectionism or impulsivity, or cognitive deficits such as impaired set-shifting ability. Another possible endophenotype is suggested by Strober et al, 1 who offer evidence that abnormalities in the neural circuitry of fear and anxiety may predispose to both anorexia nervosa and anxiety disorders.…”

“…In an elegant study, Strober et al 1 demonstrates that various anxiety disorders coaggregate with anorexia nervosa in families. These results add to a growing literature suggesting that eating disorders display familial coaggregation with anxiety disorders [2][3][4][5] and mood disorders.…”