Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Int J Eat Disord. 2022 Aug;55(8):1130-1142. doi: 10.1002/eat.23771. Epub 2022 Jul 9.
Studies on parental socioeconomic status (SES) and family risk factors for eating disorders (EDs) have yielded inconsistent results; however, several studies have identified high parental educational attainment as a risk factor. The aim was to evaluate associations of parental SES and family composition with anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS) in the offspring, adjusting for parental age and parental mental health.
The cohort included women born in Denmark between January 1, 1989 and December 31, 2010, derived from Danish national registers. Each person was followed from their sixth birthday until onset of the disorder of interest or to December 31, 2016. Exposure variables were: childhood SES, defined as individually evaluated parental level of income, occupation, and education; sibling status; and family composition. Outcomes were: AN, BN, EDNOS, and major depressive disorder (MDD), included as a psychiatric comparison disorder. Risks were estimated using Cox proportional hazards.
High parental SES was associated with increased risk of especially AN, and less so BN and EDNOS, in offspring. In comparison, low SES was associated with a higher risk of MDD. No differences between maternal or paternal socioeconomic risk factors were found. Family composition and sibling status showed limited influence on ED risk.
SES shows opposite associations with AN than MDD, whereas associations with BN and EDNOS are intermediate. The socioeconomic backdrop of AN differs markedly from that reported in other psychiatric disorders. Whether that is due to genetic and/or environmental factors remains unknown.
Parental socioeconomic background (SES) may influence eating disorders risk in offspring somewhat differently than other psychiatric disorders. In Denmark, higher parental SES was associated with increased risk of, particularly, anorexia nervosa (AN). Importantly AN does strike across the SES spectrum. We must ensure that individuals of all backgrounds have equal access to care and are equally likely to be detected and treated appropriately for eating disorders.
关于父母社会经济地位（SES）和饮食失调（EDs）家庭风险因素的研究结果不一致；然而，有几项研究已经确定了高父母教育程度是一个风险因素。目的是评估父母 SES 和家庭结构与厌食症（AN）、贪食症（BN）和未特指的饮食失调（EDNOS）在后代中的关联，同时调整父母年龄和父母心理健康。
该队列包括 1989 年 1 月 1 日至 2010 年 12 月 31 日期间在丹麦出生的女性，源自丹麦国家登记处。每个人从他们的六岁生日开始被随访，直到出现感兴趣的疾病或 2016 年 12 月 31 日。暴露变量为：儿童 SES，定义为个体评估的父母收入、职业和教育水平；兄弟姐妹状况；和家庭结构。结果为：AN、BN、EDNOS 和重度抑郁症（MDD），包括作为一种精神科比较疾病。使用 Cox 比例风险估计风险。
高 SES 父母与后代 AN 的风险增加有关，尤其是 BN 和 EDNOS 的风险较小。相比之下，低 SES 与 MDD 的风险增加有关。未发现母亲或父亲社会经济危险因素之间的差异。家庭结构和兄弟姐妹状况对 ED 风险的影响有限。
SES 与 AN 的关联与 MDD 相反，而与 BN 和 EDNOS 的关联则处于中间。AN 的社会经济背景与其他精神科疾病报告的明显不同。这是由于遗传和/或环境因素造成的，目前尚不清楚。
父母的社会经济背景（SES）可能会以与其他精神科疾病略有不同的方式影响后代的饮食失调风险。在丹麦，较高的父母 SES 与 AN 的风险增加有关，特别是 AN。重要的是，AN 确实跨越了 SES 范围。我们必须确保所有背景的个人都能平等获得护理，并平等地有可能被发现并得到适当的治疗。
