Clinical and Demographic Distinctions in Eating Disorders with Comorbid Anxiety and Depression: A Cross-Sectional Study

Abstract

Background: Eating disorders (EDs) are frequently exacerbated by comorbid anxiety and depression, complicating clinical presentation and treatment outcomes. This study investigates the impact of these comorbidities on ED subtypes, demographic factors, and additional mental health comorbidities.

Methods: We conducted a cross-sectional analysis using data from the UK Eating Disorders Genetics Initiative (EDGI), encompassing 9,683 individuals diagnosed with various EDs and categorized based on their anxiety and depression status. Statistical methods including chi- square tests and logistic regression models, were used to assess associations between comorbid depression and anxiety and different clinical characteristics.

Results: Comorbid anxiety and depression were significantly associated with more severe ED presentations, particularly in Binge Eating Disorder (X2 = 2017.3, p < 2.2e-16), Anorexia Nervosa (X2 = 1582, p < 2.2e-16), and Bulimia Nervosa (X2 = 1191.9, p < 2.2e-16). Patients with both conditions were generally older (mean age = 30.5 years) compared to those with neither comorbidities (mean age = 28.0 years), with a higher prevalence observed in females (p = 0.02793). Although these comorbidities did not significantly influence the prevalence of most other psychiatric disorders, they were strongly associated with PTSD (p = 0.0313) and psychosis (X2 = 326.18, p < 2.2e-16). Neurodevelopmental disorders, particularly autism spectrum disorder (ASD), showed significant correlations with anxiety and depression (OR = 7.62, p < 0.001).

Conclusions: Anxiety and depression markedly influence the clinical complexity of EDs, highlighting the necessity for integrated, individualized treatment strategies. Further longitudinal research is warranted to elucidate these relationships and inform therapeutic approaches.