Attar Salma, Jomaah Jinane, El Khoury Rhéa, Cordahi Colin, Seneque Maude, Courtet Philippe, Bou Khalil Rami, Guillaume Sebastien
Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon.
Department of Psychiatry, Faculty of Medicine, Saint Joseph University, Achrafieh, Beirut, Lebanon.
J Eat Disord. 2024 Sep 6;12(1):135. doi: 10.1186/s40337-024-01090-0.
Obsessive-compulsive disorder (OCD) and eating disorders (ED) share common features, including the presence of obsessions and compulsions, and they often co-occur. Additionally, there is a significant comorbidity between ED and childhood traumatic experiences (CTE), as well as between CTE and OCD. Various biological and environmental factors have been proposed to explain the connection between ED, OCD, and CTE. This study explores the link between CTE and the comorbidity of ED and OCD, with the hypothesis that specific types of CTE may increase the risk of developing OCD in individuals with ED.
Participants (N = 562) were enrolled at an eating disorder unit in Montpellier, France, between March 2013 and January 2020. The Childhood Trauma Questionnaire (CTQ), Eating Disorder Examination Questionnaire (EDE-Q), and Mini International Neuropsychiatric Interview (MINI) were used to evaluate childhood maltreatment, assess clinical characteristics associated with ED, and categorize participants into two groups: patients with and without OCD.
Bivariate analysis revealed that patients with comorbid ED and OCD had higher EDE-Q scores (p < 0.001), more anxiety disorders (p < 0.001), depressive disorders (p = 0.02), post-traumatic stress disorder (PTSD) (p < 0.001), and a higher incidence of sexual abuse (p < 0.001) and physical neglect (p = 0.04) compared to those without OCD. Multivariate analysis showed that the association between CTE and OCD was influenced by the presence of an anxiety disorder (p = 0.01) and a higher EDE-Q total score (p = 0.03), with a significant association with a history of sexual abuse (p = 0.04).
This demonstrates that CTE increases the risk of comorbid OCD in ED patients, correlating with more clinically severe ED and a higher likelihood of anxiety disorders.
强迫症（OCD）和进食障碍（ED）有共同特征，包括存在强迫观念和强迫行为，且常同时出现。此外，进食障碍与儿童期创伤经历（CTE）之间、以及儿童期创伤经历与强迫症之间存在显著的共病情况。已提出多种生物和环境因素来解释进食障碍、强迫症和儿童期创伤经历之间的联系。本研究探讨儿童期创伤经历与进食障碍和强迫症共病之间的联系，假设特定类型的儿童期创伤经历可能会增加患有进食障碍的个体患强迫症的风险。
2013年3月至2020年1月期间，在法国蒙彼利埃的一个进食障碍科招募了参与者（N = 562）。使用儿童创伤问卷（CTQ）、进食障碍检查问卷（EDE-Q）和迷你国际神经精神病学访谈（MINI）来评估儿童期虐待情况、评估与进食障碍相关的临床特征，并将参与者分为两组：有强迫症和无强迫症的患者。
双变量分析显示，与无强迫症的患者相比，患有共病进食障碍和强迫症的患者EDE-Q得分更高（p < 0.001），焦虑症（p < 0.001）、抑郁症（p = 0.02）、创伤后应激障碍（PTSD）（p < 0.001）更多，性虐待（p < 0.001）和身体忽视（p = 0.04）的发生率更高。多变量分析表明，儿童期创伤经历与强迫症之间的关联受焦虑症的存在（p = 0.01）和更高的EDE-Q总分（p = 0.03）影响，与性虐待史有显著关联（p = 0.04）。
这表明儿童期创伤经历会增加进食障碍患者共病强迫症的风险，与临床上更严重的进食障碍以及更高的焦虑症发生率相关。
