Childhood abuse and risk of eating disorders in women.

BACKGROUND

Eating disorders are one of the most common psychiatric disorders among women. Little is known about underlying causes.

METHODS

To assess the association between childhood violence victimization and eating disorders, we performed a case-control study of women participating in the Harvard Study of Moods and Cycles, a population-based sample of women 36 to 44 years of age. Cases were women who met the diagnostic criteria for anorexia nervosa, bulimia nervosa, or binge-eating disorder after a structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). A self-administered questionnaire was used to assess a history of abuse as a child.

RESULTS

Compared with women who reported no abuse, women who reported childhood physical abuse had twice the odds of suffering from subclinical eating disorder symptoms (odds ratio [OR] = 2.0; 95% confidence interval [CI] = 1.3-3.3) or meeting DSM-IV criteria for an eating disorder (2.1; 1.1-4.2). Women who reported both physical and sexual abuse during childhood had 3 times the odds of developing eating disorder symptoms (3.0; 1.3-6.8) and nearly 4 times the odds of meeting DSM-IV criteria for an eating disorder (3.9; 1.3-11.5). These associations persisted within the subgroup of women with no depression antecedent to first onset of an eating disorder.

CONCLUSIONS

The present study provides additional evidence of an association between preadolescent trauma and psychiatric morbidity.