Eighteen-year trajectories of depressive symptoms in mothers with a lifetime eating disorder: findings from the ALSPAC cohort

Yu Wei Chua, Gemma Lewis, Abigail Easter , Glyn Lewis, Francesca Solmi

Research output: Contribution to journalArticle

Abstract

Background
Two longitudinal studies have shown that depressive symptoms in women with eating disorders might improve in the antenatal and early postnatal periods. No study has followed up women beyond 8 months postnatal.

Aims
To investigate long-term trajectories of depressive symptoms in mothers with lifetime self-reported eating disorders.

Method
Using data from the Avon Longitudinal Study of Parents and Children and multilevel growth curves we modelled trajectories of depressive symptoms from the 18th week of pregnancy to 18 years postnatal in women with lifetime self-reported anorexia nervosa, bulimia nervosa or both anorexia and bulimia nervosa. As sensitivity analyses we also investigated these trajectories using quintiles of a continuous measure of body image in pregnancy.

Results
Of the 9276 women in our main sample, 126 (1.4%) reported a lifetime diagnosis of anorexia nervosa, 153 (1.6%) of bulimia nervosa and 60 (0.6%) of both anorexia and bulimia nervosa. Women with lifetime eating disorders had greater depressive symptoms scores than women with no eating disorders, before and after adjustment for confounders (anorexia nervosa: 2.10, 95% CI 1.36–2.83; bulimia nervosa: 2.28, 95% CI: 1.61–2.94, both anorexia and bulimia nervosa: 2.86, 95% CI 1.81–3.90). We also observed a dose–response association between greater body image and eating concerns in pregnancy and more severe trajectories of depressive symptoms, even after adjusting for lifetime eating disorders which also remained independently associated with greater depressive symptoms.

Conclusions
Women with eating disorders experience persistently greater depressive symptoms across the life-course. More training for practitioners and midwives on how to recognise eating disorders in pregnancy could help to identify depressive symptoms and reduce the long-term burden of disease resulting from this comorbidity.
LanguageEnglish
Number of pages7
JournalBritish Journal of Psychiatry
Early online date14 May 2019
DOIs
Publication statusE-pub ahead of print - 14 May 2019

Fingerprint

eating disorder
Bulimia Nervosa
Anorexia Nervosa
Mothers
Depression
anorexia
Pregnancy
Body Image
pregnancy
Longitudinal Studies
body image
Feeding and Eating Disorders
Midwifery
longitudinal study
Comorbidity
Eating
Parents
midwife
comorbidity
eating behavior

Keywords

  • ALSPAC
  • eating disorders
  • depression
  • parental mental health
  • perinatal mental health

Cite this

@article{98ff758212c542858512b06b31546a80,
title = "Eighteen-year trajectories of depressive symptoms in mothers with a lifetime eating disorder: findings from the ALSPAC cohort",
abstract = "BackgroundTwo longitudinal studies have shown that depressive symptoms in women with eating disorders might improve in the antenatal and early postnatal periods. No study has followed up women beyond 8 months postnatal.AimsTo investigate long-term trajectories of depressive symptoms in mothers with lifetime self-reported eating disorders.MethodUsing data from the Avon Longitudinal Study of Parents and Children and multilevel growth curves we modelled trajectories of depressive symptoms from the 18th week of pregnancy to 18 years postnatal in women with lifetime self-reported anorexia nervosa, bulimia nervosa or both anorexia and bulimia nervosa. As sensitivity analyses we also investigated these trajectories using quintiles of a continuous measure of body image in pregnancy.ResultsOf the 9276 women in our main sample, 126 (1.4{\%}) reported a lifetime diagnosis of anorexia nervosa, 153 (1.6{\%}) of bulimia nervosa and 60 (0.6{\%}) of both anorexia and bulimia nervosa. Women with lifetime eating disorders had greater depressive symptoms scores than women with no eating disorders, before and after adjustment for confounders (anorexia nervosa: 2.10, 95{\%} CI 1.36–2.83; bulimia nervosa: 2.28, 95{\%} CI: 1.61–2.94, both anorexia and bulimia nervosa: 2.86, 95{\%} CI 1.81–3.90). We also observed a dose–response association between greater body image and eating concerns in pregnancy and more severe trajectories of depressive symptoms, even after adjusting for lifetime eating disorders which also remained independently associated with greater depressive symptoms.ConclusionsWomen with eating disorders experience persistently greater depressive symptoms across the life-course. More training for practitioners and midwives on how to recognise eating disorders in pregnancy could help to identify depressive symptoms and reduce the long-term burden of disease resulting from this comorbidity.",
keywords = "ALSPAC, eating disorders, depression, parental mental health, perinatal mental health",
author = "Chua, {Yu Wei} and Gemma Lewis and Abigail Easter and Glyn Lewis and Francesca Solmi",
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doi = "10.1192/bjp.2019.89",
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journal = "British Journal of Psychiatry",
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}

Eighteen-year trajectories of depressive symptoms in mothers with a lifetime eating disorder : findings from the ALSPAC cohort. / Chua, Yu Wei; Lewis, Gemma ; Easter , Abigail ; Lewis, Glyn ; Solmi, Francesca .

In: British Journal of Psychiatry , 14.05.2019.

Research output: Contribution to journalArticle

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AU - Easter , Abigail

AU - Lewis, Glyn

AU - Solmi, Francesca

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N2 - BackgroundTwo longitudinal studies have shown that depressive symptoms in women with eating disorders might improve in the antenatal and early postnatal periods. No study has followed up women beyond 8 months postnatal.AimsTo investigate long-term trajectories of depressive symptoms in mothers with lifetime self-reported eating disorders.MethodUsing data from the Avon Longitudinal Study of Parents and Children and multilevel growth curves we modelled trajectories of depressive symptoms from the 18th week of pregnancy to 18 years postnatal in women with lifetime self-reported anorexia nervosa, bulimia nervosa or both anorexia and bulimia nervosa. As sensitivity analyses we also investigated these trajectories using quintiles of a continuous measure of body image in pregnancy.ResultsOf the 9276 women in our main sample, 126 (1.4%) reported a lifetime diagnosis of anorexia nervosa, 153 (1.6%) of bulimia nervosa and 60 (0.6%) of both anorexia and bulimia nervosa. Women with lifetime eating disorders had greater depressive symptoms scores than women with no eating disorders, before and after adjustment for confounders (anorexia nervosa: 2.10, 95% CI 1.36–2.83; bulimia nervosa: 2.28, 95% CI: 1.61–2.94, both anorexia and bulimia nervosa: 2.86, 95% CI 1.81–3.90). We also observed a dose–response association between greater body image and eating concerns in pregnancy and more severe trajectories of depressive symptoms, even after adjusting for lifetime eating disorders which also remained independently associated with greater depressive symptoms.ConclusionsWomen with eating disorders experience persistently greater depressive symptoms across the life-course. More training for practitioners and midwives on how to recognise eating disorders in pregnancy could help to identify depressive symptoms and reduce the long-term burden of disease resulting from this comorbidity.

AB - BackgroundTwo longitudinal studies have shown that depressive symptoms in women with eating disorders might improve in the antenatal and early postnatal periods. No study has followed up women beyond 8 months postnatal.AimsTo investigate long-term trajectories of depressive symptoms in mothers with lifetime self-reported eating disorders.MethodUsing data from the Avon Longitudinal Study of Parents and Children and multilevel growth curves we modelled trajectories of depressive symptoms from the 18th week of pregnancy to 18 years postnatal in women with lifetime self-reported anorexia nervosa, bulimia nervosa or both anorexia and bulimia nervosa. As sensitivity analyses we also investigated these trajectories using quintiles of a continuous measure of body image in pregnancy.ResultsOf the 9276 women in our main sample, 126 (1.4%) reported a lifetime diagnosis of anorexia nervosa, 153 (1.6%) of bulimia nervosa and 60 (0.6%) of both anorexia and bulimia nervosa. Women with lifetime eating disorders had greater depressive symptoms scores than women with no eating disorders, before and after adjustment for confounders (anorexia nervosa: 2.10, 95% CI 1.36–2.83; bulimia nervosa: 2.28, 95% CI: 1.61–2.94, both anorexia and bulimia nervosa: 2.86, 95% CI 1.81–3.90). We also observed a dose–response association between greater body image and eating concerns in pregnancy and more severe trajectories of depressive symptoms, even after adjusting for lifetime eating disorders which also remained independently associated with greater depressive symptoms.ConclusionsWomen with eating disorders experience persistently greater depressive symptoms across the life-course. More training for practitioners and midwives on how to recognise eating disorders in pregnancy could help to identify depressive symptoms and reduce the long-term burden of disease resulting from this comorbidity.

KW - ALSPAC

KW - eating disorders

KW - depression

KW - parental mental health

KW - perinatal mental health

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DO - 10.1192/bjp.2019.89

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JF - British Journal of Psychiatry

SN - 0007-1250

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