Musial Agnieszka, Foye Una, Kakar Saakshi, Jewell Tom, Treasure Janet, Kalsi Gursharan, Smith Iona, Meldrum Laura, Bristow Shannon, Marsh Ian, Malouf Chelsea Mika, Arora Jahnavi, Davies Helena, Dutta Rina, Schmidt Ulrike, Breen Gerome, Herle Moritz
Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
Department of Mental Health Nursing, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.
Eur Psychiatry. 2025 Feb 19;68(1):1-31. doi: 10.1192/j.eurpsy.2025.25.
Eating disorders, including anorexia nervosa, bulimia nervosa and binge eating disorder, are psychiatric conditions associated with high mortality rates, particularly due to suicide. Although eating disorders are strongly associated with suicidal ideation, attempts, and fatalities, the precise relationship between these conditions remains poorly understood. While substantial genetic influences have been identified for both eating disorders and suicidality, the shared genetics contributing to their co-occurrence remain unclear. In this study, we utilized a multivariate approach to examine the shared genetic architecture of eating disorder symptoms, suicidal thoughts and behaviors in ~20,000 participants from the COVID-19 Psychiatry and Neurological Genetics (COPING) study. We applied individual-level structural equation modeling to explore the factor structure underlying eating disorder symptoms and suicidal ideation, followed by genetic correlation analyses. We modeled the general factor of susceptibility to eating disorders and suicidal ideation that was as strongly genetically influenced as both conditions, with mean SNP heritability of 9%. Importantly, despite the frequent co-occurrence of eating disorders with other psychiatric conditions, our findings highlight the specificity of the relationship between eating disorders and suicidality, independent of other co-occurring psychopathology, such as depression and anxiety. This specificity highlights the need for targeted approaches in understanding the shared susceptibility factors.
饮食失调，包括神经性厌食症、神经性贪食症和暴饮暴食症，是与高死亡率相关的精神疾病，尤其是因自杀导致的死亡率。尽管饮食失调与自杀观念、自杀未遂及自杀死亡密切相关，但这些病症之间的确切关系仍知之甚少。虽然已经确定饮食失调和自杀倾向都受到大量遗传因素的影响，但导致它们共同出现的共享遗传学因素仍不明确。在本研究中，我们采用多变量方法，对来自新冠疫情期间精神科与神经遗传学（COPING）研究的约20,000名参与者的饮食失调症状、自杀想法和行为的共享遗传结构进行了研究。我们应用个体水平的结构方程模型来探索饮食失调症状和自杀观念背后的因素结构，随后进行遗传相关性分析。我们对饮食失调和自杀观念易感性的一般因素进行了建模，该因素受到的遗传影响与这两种病症一样强烈，平均单核苷酸多态性遗传率为9%。重要的是，尽管饮食失调经常与其他精神疾病同时出现，但我们的研究结果突出了饮食失调与自杀倾向之间关系的特异性，独立于其他同时出现的精神病理学，如抑郁和焦虑。这种特异性凸显了在理解共享易感性因素时采用针对性方法的必要性。
