The network structure of mania symptoms differs between people with and without binge eating

Helena L Davies; Alicia J Peel; Jessica Mundy; Dina Monssen; Saakshi Kakar; Molly R Davies; Brett N Adey; Chérie Armour; Gursharan Kalsi; Yuhao Lin; Ian Marsh; Henry C Rogers; James T R Walters; Moritz Herle; Kiran Glen; Chelsea Mika Malouf; Emily J Kelly; Thalia C Eley; Janet Treasure; Gerome Breen; Christopher Hübel

doi:10.1111/bdi.13355

The network structure of mania symptoms differs between people with and without binge eating

Bipolar Disord. 2023 Nov;25(7):592-607. doi: 10.1111/bdi.13355. Epub 2023 Jun 12.

Authors

Helena L Davies¹, Alicia J Peel¹, Jessica Mundy^{1

2}, Dina Monssen^{1

2}, Saakshi Kakar^{1

2}, Molly R Davies^{1

2}, Brett N Adey^{1

2}, Chérie Armour³, Gursharan Kalsi^{1

2}, Yuhao Lin^{1

2}, Ian Marsh^{1

2}, Henry C Rogers^{1

2}, James T R Walters⁴, Moritz Herle^{1

5}, Kiran Glen^{1

2}, Chelsea Mika Malouf^{1

2}, Emily J Kelly^{1

2}, Thalia C Eley^{1

2}, Janet Treasure^{6

7}, Gerome Breen^{1

2}, Christopher Hübel^{1

2

8}

Affiliations

¹ Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
² National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK.
³ Research Centre for Stress, Trauma and Related Conditions (STARC), School of Psychology, Queen's University Belfast (QUB), Belfast, Northern Ireland, UK.
⁴ Division of Psychiatry and Clinical Neurosciences, National Centre for Mental Health and MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.
⁵ Department of Biostatistics and Health Informatics, King's College London, London, UK.
⁶ Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁷ South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK.
⁸ National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark.

Abstract

Objectives: People with bipolar disorder who also report binge eating have increased psychopathology and greater impairment than those without binge eating. Whether this co-occurrence is related to binge eating as a symptom or presents differently across full-syndrome eating disorders with binge eating is unclear.

Methods: We first compared networks of 13 lifetime mania symptoms in 34,226 participants from the United Kingdom's National Institute for Health and Care Research BioResource with (n = 12,104) and without (n = 22,122) lifetime binge eating. Second, in the subsample with binge eating, we compared networks of mania symptoms in participants with lifetime anorexia nervosa binge-eating/purging (n = 825), bulimia nervosa (n = 3737), and binge-eating disorder (n = 3648).

Results: People with binge eating endorsed every mania symptom significantly more often than those without binge eating. Within the subsample, people with bulimia nervosa most often had the highest endorsement rate of each mania symptom. We found significant differences in network parameter statistics, including network structure (M = 0.25, p = 0.001) and global strength (S = 1.84, p = 0.002) when comparing the binge eating with no binge-eating participants. However, network structure differences were sensitive to reductions in sample size and the greater density of the latter network was explained by the large proportion of participants (34%) without mania symptoms. The structure of the anorexia nervosa binge-eating/purging network differed from the bulimia nervosa network (M = 0.66, p = 0.001), but the result was unstable.

Conclusions: Our results suggest that the presence and structure of mania symptoms may be more associated with binge eating as a symptom rather than any specific binge-type eating disorder. Further research with larger sample sizes is required to confirm our findings.

Keywords: anorexia nervosa; binge-eating disorder; bipolar disorder; bulimia nervosa; diagnosis; network analysis; signs and symptoms.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anorexia Nervosa* / diagnosis
Binge-Eating Disorder* / complications
Binge-Eating Disorder* / diagnosis
Bipolar Disorder*
Bulimia* / diagnosis
Humans
Mania

Abstract

Publication types

MeSH terms

Grants and funding