Familial factors in anorexia nervosa: a community-based study.

A group of 51 cases with teenage anorexia nervosa (AN; including a total population of cases from one birth cohort) were compared with a sex-, age-, and school-matched group of 51 cases on familial factors. The subjects were examined at age 16 and 21 years. In the first study, mothers of both groups were interviewed regarding physical and psychiatric disorders among first-degree relatives. In the followup study, the subjects were interviewed according to the same structured interview schedule. The data from these interviews were deidentified, and case notes were prepared by a clinician blind to group status. The randomly assorted case notes were then submitted to an experienced psychiatrist who also was blind to group status. There were more relatives with a history and symptoms suggestive of pervasive developmental disorders (PDD) and major depression in the AN group. There was also significantly more death in first-degree relatives of anorexia nervosa cases. In respect to many axis I DSM-IV diagnoses, including eating disorders and substance abuse, there were no significant differences across groups. Instead we found PDD symptoms, major depression, and death in first-degree relatives to be important in the AN group.