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Development of Disordered Eating Behaviors and Comorbid Depressive Symptoms in Adolescence: Neural and Psychopathological Predictors

  • Author Footnotes
    ∗ ZZ and LR contributed equally to this work.
    Zuo Zhang
    Footnotes
    ∗ ZZ and LR contributed equally to this work.
    Affiliations
    Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
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  • Lauren Robinson
    Affiliations
    Section of Eating Disorders, Department of Psychological Medicine, London, United Kingdom
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  • Tianye Jia
    Affiliations
    Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom

    Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China

    Ministry of Education–Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Shanghai, China
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  • Erin Burke Quinlan
    Affiliations
    Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
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  • Nicole Tay
    Affiliations
    Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
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  • Congying Chu
    Affiliations
    Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
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  • Edward D. Barker
    Affiliations
    Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom

    Developmental Psychopathology Lab, Department of Psychology, King’s College London, London, United Kingdom
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  • Tobias Banaschewski
    Affiliations
    Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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  • Gareth J. Barker
    Affiliations
    Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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  • Arun L.W. Bokde
    Affiliations
    Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
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  • Herta Flor
    Affiliations
    Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
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  • Antoine Grigis
    Affiliations
    NeuroSpin, Commissariat à l’Énergie Atomique, Université Paris-Saclay, Gif-sur-Yvette, France
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  • Hugh Garavan
    Affiliations
    Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont, USA
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  • Penny Gowland
    Affiliations
    Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, United Kingdom
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  • Andreas Heinz
    Affiliations
    Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Charite Mitte, Berlin, Germany
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  • Bernd Ittermann
    Affiliations
    Physikalisch-Technische Bundesanstalt, Braunschweig and Berlin, Germany
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  • Jean-Luc Martinot
    Affiliations
    Institut National de la Santé et de la Recherche Médicale U A10 “Developmental Trajectories and Psychiatry”, Université Paris-Saclay, École Normale Supérieure Paris-Saclay, Centre National de la Recherche Scientifique, Centre Borelli, Gif-sur-Yvette, France
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  • Argyris Stringaris
    Affiliations
    National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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  • Jani Penttilä
    Affiliations
    Department of Social and Health Care, Psychosocial Services Adolescent Outpatient Clinic, Kauppakatu, Lahti, Finland
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  • Betteke van Noort
    Affiliations
    Medical School Berlin, Berlin, Germany
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  • Yvonne Grimmer
    Affiliations
    Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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  • Marie-Laure Paillère Martinot
    Affiliations
    Institut National de la Santé et de la Recherche Médicale Unit 1000 “Neuroimaging & Psychiatry”, Université Paris-Saclay, Université Paris Descartes, Sorbonne Université, Paris, France

    Department of Child and Adolescent Psychiatry, Assistance Publique–Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
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  • Corinna Isensee
    Affiliations
    Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
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  • Andreas Becker
    Affiliations
    Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
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  • Frauke Nees
    Affiliations
    Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
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  • Dimitri Papadopoulos Orfanos
    Affiliations
    NeuroSpin, Commissariat à l’Énergie Atomique, Université Paris-Saclay, Gif-sur-Yvette, France
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  • Tomáš Paus
    Affiliations
    Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada

    Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
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  • Luise Poustka
    Affiliations
    Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
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  • Sarah Hohmann
    Affiliations
    Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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  • Juliane H. Fröhner
    Affiliations
    Department of Psychiatry and Neuroimaging Center, Technische Universitat Dresden, Dresden, Germany
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  • Michael N. Smolka
    Affiliations
    Department of Psychiatry and Neuroimaging Center, Technische Universitat Dresden, Dresden, Germany
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  • Henrik Walter
    Affiliations
    Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Charite Mitte, Berlin, Germany
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  • Robert Whelan
    Affiliations
    School of Psychology and Global Brain Health Institute, Trinity College, Dublin, Ireland
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  • Gunter Schumann
    Affiliations
    Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom

    Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China

    Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Charite Mitte, Berlin, Germany
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  • Ulrike Schmidt
    Affiliations
    Section of Eating Disorders, Department of Psychological Medicine, London, United Kingdom

    The Eating Disorders Service, Maudsley Hospital, South London, and Maudsley NHS Foundation Trust, London, United Kingdom
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  • Sylvane Desrivières
    Correspondence
    Address correspondence to Sylvane Desrivières, Ph.D.
    Affiliations
    Centre for Population Neuroscience and Precision Medicine, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
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  • Author Footnotes
    ∗ ZZ and LR contributed equally to this work.

      Abstract

      Background

      Eating disorders are common in adolescence and are devastating and strongly comorbid with other psychiatric disorders. Yet little is known about their etiology, knowing which would aid in developing effective preventive measures.

      Methods

      Longitudinal assessments of disordered eating behaviors (DEBs)—binge-eating, purging, and dieting—and comorbid psychopathology were measured in 1386 adolescents from the IMAGEN study. Development of DEBs and associated mental health problems was investigated by comparing participants who reported symptoms at ages 16 or 19 years, but not at age 14 years, with asymptomatic control participants. Voxel-based morphometry and psychopathological differences at age 14 were investigated to identify risk factors for the development of DEBs and associated mental health problems.

      Results

      DEBs and depressive symptoms developed together. Emotional and behavioral problems, including symptoms of attention-deficit/hyperactivity disorder and conduct disorder, predated their development. Alterations in frontostriatal brain areas also predated the development of DEBs and depressive symptoms. Specifically, development of binge-eating was predicted by higher gray matter volumes in the right putamen/globus pallidus at age 14. Conversely, development of purging and depressive symptoms was predicted by lower volumes in the medial orbitofrontal, dorsomedial, and dorsolateral prefrontal cortices. Lower gray matter volumes in the orbitofrontal and anterior cingulate cortices mediated the relationship between attention-deficit/hyperactivity disorder and conduct disorder symptoms and future purging and depressive symptoms.

      Conclusions

      These findings suggest that alterations in frontal brain circuits are part of the shared etiology among eating disorders, attention-deficit/hyperactivity disorder, conduct disorder, and depression and highlight the importance of a transdiagnostic approach to treating these conditions.

      Keywords

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      Linked Article

      • New Evidence on What Predicts the Development of Eating Disorders in Adolescents
        Biological PsychiatryVol. 90Issue 12
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          Despite the high risk of medical complications and mortality in patients with eating disorders (EDs), the identification of risk factors and predictors of these disorders remains largely unknown. The recognition of predictors is particularly important in view of developing preventive strategies for targeted groups of high-risk subjects (1). In the field of EDs, high-risk subjects are usually identified by means of self-reported questionnaires and mainly include those experiencing symptoms of the disorder, such as high levels of body dissatisfaction and clinical perfectionism in individuals who are dieting or using other compensatory behaviors to control body weight and shape.
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