School Achievement and Risk of Eating Disorders in a Swedish National Cohort

Abstract

Objective High achievement in school has been associated with increased risk of eating disorders, including anorexia nervosa (AN) and bulimia nervosa (BN), but causality of these relationships is unclear. We sought to examine the association between school achievement and AN or BN in a national cohort and to determine the possible contribution of familial confounding using a co-relative design. Method The national cohort study involved 1,800,643 persons born in Sweden during 1972-1990 who were still living in Sweden at age 16 years, followed up for AN and BN identified from inpatient and outpatient diagnoses through 2012. We used Cox regression to examine the association between school achievement and subsequent risk of AN or BN, and stratified Cox models to examine the gradient in this association across different strata of co-relative pairs (first cousins, half siblings, full siblings). Results School achievement was positively associated with risk of AN among females and males (hazard ratio per additional 1 standard deviation, females: 1.29; 95% CI, 1.25-1.33; males: 1.29; 95% CI, 1.10-1.52), and risk of BN among females but not males (females: 1.16; 95% CI, 1.11-1.20; males: 1.05; 95% CI, 0.84-1.31). In co-relative analyses, as the degree of shared genetic and environmental factors increased (e.g., from first-cousin to full-sibling pairs), the association between school achievement and AN or BN substantially decreased. Conclusion In this large national cohort study, high achievement in school was associated with increased risk of AN and BN, but this appeared to be explained by unmeasured familial (genetic and environmental) factors.

NR2A- and NR2B-NMDA receptors and drebrin within postsynaptic spines of the hippocampus correlate with hunger-evoked exercise

“…Supporting this prediction, other cohorts of adolescent female rats that underwent identical ABA and food-restriction-alone treatments exhibited faster acquisition of spatial memory, relative to the CON animals, after recovering from ABA for a week (Aoki et al 2016; Chowdhury et al 2014b). Consistent with this idea, individuals diagnosed with AN are often characterized to be perfectionists, high achievers, and goal-oriented (Kaye et al 2009; Bachner-Melman et al 2007; Sundquist et al 2016; Dura and Bornstein 1989; Beals 2004). …”

Genome-wide association study of school grades identifies a genetic overlap between language ability, psychopathology and creativity

“…The directions of the associations were in line with previous studies on the association of school performance with risk for psychiatric disorders. 4,5,[14][15][16]31 The genetic correlations of E1 with the psychiatric disorders mirrored the corresponding phenotypic associations in all except SCZ ( Fig. 3b; Supplementary Table 9).…”

“…9 For most of the psychiatric disorders the genetic correlations with educational attainment align with the corresponding phenotypic associations with school performance reported in epidemiological studies. [14][15][16] For some disorders such as SCZ, however, the genetic correlations do not correspond to the phenotypic associations. 17 Although clinical and epidemiological studies have documented that individuals with-or at risk for-SCZ perform poorly in school 4 and score low in neurocognitive assessments, 18 the genetic correlation of SCZ with educational attainment is not negative, but rather positive, albeit weak.…”

Disaggregating the predictive effects of impaired psychosocial functioning on future DSM‐5 eating disorder onset in high‐risk female adolescents

“…We did not collect data on actual school performance and high shame could either signal actual or perceived poor academic performance that indicate high perfectionism and performance pressure (Forbush, Heatherton, & Keel, ) or fear of negative evaluation (Levinson & Rodebaugh, ), which have found to be associated with eating disorders. A prospective study found that high scholastic performance increased risk for the development of AN and BN (Sundquist, Ohlsson, Winkleby, Sundquist, & Crump, ).Overall, the CTA results are clearly hypothesis‐generating rather than hypothesis‐confirming, but suggest intriguing possibilities for future research.…”