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Childhood maltreatment and eating disorder pathology: a systematic review and dose-response meta-analysis

Published online by Cambridge University Press:  19 January 2017

M. L. Molendijk ,
H. W. Hoek ,
T. D. Brewerton  and
B. M. Elzinga
M. L. Molendijk*
Affiliation:
Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, The Netherlands Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
H. W. Hoek
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands Department of Epidemiology, Columbia University, New York, USA
T. D. Brewerton
Affiliation:
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
B. M. Elzinga
Affiliation:
Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, The Netherlands Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
*
*Address for correspondence: M. L. Molendijk, Ph.D., Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, The Netherlands and Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands. (Email: m.l.molendijk@fsw.leidenuniv.nl)
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Abstract

Background

Meta-analyses have established a high prevalence of childhood maltreatment (CM) in patients with eating disorders (EDs) relative to the general population. Whether the prevalence of CM in EDs is also high relative to that in other mental disorders has not yet been established through meta-analyses nor to what extent CM affects defining features of EDs, such as number of binge/purge episodes or age at onset. Our aim is to provide meta-analyses on the associations between exposure to CM (i.e. emotional, physical and sexual abuse) on the occurrence of all types of EDs and its defining features.

Method

Systematic review and meta-analyses. Databases were searched until 4 June 2016.

Results

CM prevalence was high in each type of ED (total N = 13 059, prevalence rates 21–59%) relative to healthy (N = 15 092, prevalence rates 1–35%) and psychiatric (N = 7736, prevalence rates 5–46%) control groups. ED patients reporting CM were more likely to be diagnosed with a co-morbid psychiatric disorder [odds ratios (ORs) range 1.41–2.46, p < 0.05] and to be suicidal (OR 2.07, p < 0.001) relative to ED subjects who were not exposed to CM. ED subjects exposed to CM also reported an earlier age at ED onset [effect size (Hedges’ g) = −0.32, p < 0.05], to suffer a more severe form of the illness (g = 0.29, p < 0.05), and to binge-purge (g = 0.31, p < 0.001) more often compared to ED patients who did not report any CM.

Conclusion

CM, regardless of type, is associated with the presence of all types of ED and with severity parameters that characterize these illnesses in a dose dependent manner.

Keywords

Anorexiabulimiachildhood abuseeating disordersmeta-analysis
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 8 , June 2017 , pp. 1402 - 1416
Copyright
Copyright © Cambridge University Press 2017 

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