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. 2022 Oct 18;10(1):150.
doi: 10.1186/s40337-022-00664-0.

Co-occurring psychotic and eating disorders in England: findings from the 2014 Adult Psychiatric Morbidity Survey

Ellen Rodgers  1 , Steven Marwaha  1   2 , Clara Humpston  3   4
Affiliations

Co-occurring psychotic and eating disorders in England: findings from the 2014 Adult Psychiatric Morbidity Survey

Ellen Rodgers et al. J Eat Disord. .

Abstract

Background: Psychotic disorders and eating disorders are complex mental illnesses associated with increased mortality and functional impairment. This study aimed to investigate the co-occurrence and relationships between eating disorders and psychotic disorders and assess the mediation effect of mood instability.

Methods: This study used data from the Adult Psychiatric Morbidity Survey (APMS) 2014, a general population-based survey in England. Participants (total N = 7546, female N = 4488, male N = 3058, mean age = 52.3 years) were categorised based on psychotic disorder status into the groups of probable psychosis, diagnosed psychosis, and healthy controls without psychosis. The dependent variable of this study was the presence or absence of an eating disorder, with mood instability as the mediator. Logistic regression and mediation analyses were conducted to assess the relationships between these variables.

Results: Both probable and diagnosed psychoses were significantly related to the presence of an eating disorder, and mood instability was found to be a mediating variable with moderate effect.

Conclusion: The present study demonstrates a significant relationship between eating disorders and psychotic disorders in the English general population, indicating higher levels of co-occurrence between these two groups of disorders than when compared with healthy controls. The findings also suggest the relationship between eating and psychotic disorders is mediated, to an extent, by the presence of mood instability traits. Future research could extend the present study's findings through assessing whether specific eating disorders are more significantly related to psychotic disorders than others.

Keywords: Comorbidity; Eating disorders; Epidemiology; Household survey; Mood instability; Psychotic disorders.

Plain language summary

Eating disorders as well as psychotic disorders pose a significant risk to those diagnosed, with anorexia nervosa having the highest mortality rate among all mental disorders. The two groups of disorders are shown to be related as those with psychotic disorders are more likely to also be diagnosed with an eating disorder. Further, the relationship between eating and psychotic disorders could be due to trait mood instability. Mood instability is defined as the rapid switching between moods that those affected cannot control easily and has been found in individuals who are diagnosed with either an eating or a psychotic disorder. This leads to the question whether mood instability is involved in the relationship between psychotic and eating disorders. As individuals with both eating and psychotic disorders experience high levels of distress and treatment is challenging, it is important to understand the nature of the relationship between these two disorders.This study used data collected from a population-based survey in England to examine whether psychotic disorders were related to eating disorders, and whether mood instability was implicated in the relationship. The study found that psychotic and eating disorders were significantly related, and mood instability had a moderate effect on the relationship.

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Conflict of interest statement

SM has received funding from Lundbeck, Sunovion and Janssen to attend educational events. Other authors declare no conflicts.

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