Characterising the psychopathological profile of children at high-risk for eating disorders

Children at familial high-risk (FHR) for eating disorders (EDs), i.e. born to mothers with EDs, are at increased risk of psychiatric morbidity, especially emotional and behavioural disorders. However, less is known about broader psychopathology and specific effects of maternal diagnoses. This study aimed to characterise the psychopathological profile of children at FHR for EDs, compared to healthy children at no familial risk (HC, i.e., with a mother with no ED). Sixty (60) children at FHR (median age 10; range = 7) and 63 HC (median age 12; range = 4) were assessed for psychopathology using the Development and Well-Being Assessment, the State and Trait Anxiety Inventory, the Strength and Difficulties Questionnaire and the Social Aptitude Scale respectively. Children at FHR exhibited more psychiatric disorders than HC (p=.02 and p=.01 respectively). Children at FHR showed more emotional disorders (p=.01) and overall more mental health difficulties, with elevated levels of emotional symptoms (p<.001), hyperactivity/inattention (p=.04), and peer relationship problems (p=.004). However, no significant differences were observed between groups in terms of state/trait anxiety. Moreover, post-pubertal development was associated with higher emotional distress and higher state anxiety levels than pre-pubertal development. Children at FHR are at increased risk of developing psychiatric disorders and psychopathology, especially in the emotional domain. Puberty may also be a critical window of risk for this group. Our findings suggest that children at FHR face an increased psychopathological burden and warrant development of interventions to support them, especially during puberty.