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Development of disordered eating behaviors and comorbid depressive symptoms in adolescence: neural and psychopathological predictors

Research output: Contribution to journalArticle

Zuo Zhang, Lauren Robinson, Tianye Jia, Erin Quinlan, Nicole Tay, Congying Chu, Edward Barker, Tobias Banaschewski, Gareth Barker, Arun L.W. Bokde, Herta Flor, Antoine Grigis, Hugh Garavan, Penny Gowland, Andreas Heinz, Bernd Ittermann, Jean-Luc Martinot, Argyris Stringaris, Jani Penttilä, Betteke van Noort & 16 more Yvonne Grimmer, Marie-Laure Paillère Martinot, Corinna Isensee, Andreas Becker, Frauke Nees, Dimitri Papadopoulos Orfanos, Tomáš Paus, Luise Poustka, Sarah Hohmann, Juliane H. Fröhner, Michael N. Smolka, Henrik Walter, Robert Whelan, Gunter Schumann, Ulrike Schmidt, Sylvane Desrivieres

Original languageEnglish
JournalBiological psychiatry
Early online date10 Jun 2020
Publication statusE-pub ahead of print - 10 Jun 2020

King's Authors


Eating disorders are common in adolescence, devastating and strongly comorbid with other psychiatric disorders. Yet, little is known about their etiology to develop effective preventive measures.

Longitudinal assessments of disordered eating behaviors (DEBs; binge-eating, purging and dieting) and comorbid psychopathology were measured in 1,386 adolescents from the IMAGEN study. Development of DEBs and associated mental health problems were investigated by comparing participants who reported symptoms at ages 16 or 19, but not at age 14 to asymptomatic controls. 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.

DEBs and depressive symptoms developed together. Emotional and behavioral problems, including symptoms of attention deficit hyperactivity disorder (ADHD) and conduct disorder (CD), predated their development. Alterations in fronto-striatal brain areas also predated the development of DEBs and depressive symptoms. Specifically, development of binge-eating was predicted by higher grey 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 grey matter volumes in the orbitofrontal and anterior cingulate cortices mediated the relationship between ADHD and CD symptoms and future purging and depressive symptoms.

These findings suggest that alterations in frontal brain circuits are part of the shared etiology between eating disorders, ADHD, CD and depression and highlight the importance of a transdiagnostic approach to treating these conditions.

eating disorders depression attention deficit hyperactivity disorder conduct disorderbiomarkersgrey matter volume

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