Parents fighting multiple battles: Comorbid psychopathology among young people with eating disorders and their parents-implications for needs, treatment allocation and treatment outcomes

Parents fighting multiple battles: Comorbid psychopathology among young people with eating disorders and their parents-implications for needs, treatment allocation and treatment outcomes

Comorbid psychopathology is common among young people with eating disorders (EDs) and impacts treatment planning and effectiveness. However, little is known about how the ‘newer’ ED diagnoses of atypical anorexia nervosa (AAN) and avoidant/ restrictive food intake disorder (ARFID) differ in terms of comorbidities compared to anorexia nervosa (AN). Additionally, while the genetic link between parental/ child vulnerability to EDs and comorbid mental health conditions is well established, little is known about the mental health of parents of young people as they present to treatment. This makes it difficult to understand the needs and potential barriers to recovery that parental mental health may have for treatment.
Objectives: To compare comorbid symptomology among individuals with AN, AAN, and AFRID. Additionally, it aimed to investigate associations between parental mental
health and expressed emotion, and if these symptoms influence treatment allocation.
Methods: Young people with EDs (n = 298) and parents (n = 373) completed a range of self-report measures prior to engaging in outpatient treatment.
Results: For young people, there was no difference between AN and AAN on any measure of comorbid symptoms. Both showed severe levels of comorbidity with roughly half exceeding the cut-point for four or more comorbid diagnoses. Young people with ARFID had comparatively less severe comorbid symptoms. Parent
symptomology was associated with constructs shown to predict treatment outcome but did not predict treatment allocation.
Conclusions: EDs are severe and complex, with comorbidity extending beyond the young person. Both young people and family comorbid symptoms warrant consideration when planning treatment.