Depression and eating disorders in early adolescence: A network analysis approach.

Abstract

Eating disorders (EDs) and depression are among the most debilitating and pervasive mental illnesses. Although they often co-occur, the relationship between EDs and depression remains poorly understood. This study used network analysis to explore the symptom-level relationship between EDs and depression among a sample of Australian adolescents completing their first year of secondary school. Adolescents (N=4,421) aged between 10 and 15 years completed the Centre for Epidemiological Depression Scale and the Eating Disorder Examination-Questionnaire. Network structure was estimated using the Gaussian graphical model and node centrality was assessed using one-step expected influence (EI) and bridge EI. "Depressed," "lonely," and "low energy" were identified as core symptoms of depression. "Shape and weight dissatisfaction," "desire to lose weight," and "preoccupation with shape or weight" were identified as core ED symptoms. "Irritable," "social eating," and "depressed" were identified as the most important nodes connecting (i.e., bridging) symptoms of depression and EDs. This study provides an important symptom-level conceptualization of the association between depression and ED symptoms in a community sample of adolescents. This preliminary evidence may guide the development of public health prevention and early intervention programs. Future research should be conducted to address the study limitations (e.g., cross-sectional design).