Aims Compared to the general population, adoptees are more often referred to specialist psychiatric treatment, exhibit increased risk of suicide and display more symptoms of attention-deficit/hyperactivity-disorder. However, little is known about the impact of being an adoptee on the risk of developing an eating disorder. The aim of the present study was to assess whether international adoptees have a higher risk for eating disorders than native Swedes. Methods In the present retrospective cohort study, data from the Swedish total population registers on individuals born between 1979 and 2005 were used to assess whether international adoptees residing in Sweden (n = 25 287) have a higher risk for anorexia nervosa (AN) and other eating disorders (OED) than non-adoptees with Swedish-born parents from the general population (n = 2 046 835). The patterns of these results were compared to those for major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and anxiety disorders to determine whether any observed effects were unique to eating disorders or reflected a more general impact on mental health outcomes. Results A survival analysis adjusting for relevant demographic covariates revealed an elevated risk of all examined psychiatric disorders in international adoptees: hazard ratios (95% confidence intervals) are 1.21 (1.04–1.41) for AN, 1.60 (1.44–1.79) for OED, 1.90 (1.81–2.00) for MDD, 1.25 (1.09–1.44) for OCD, and 1.69 (1.60–1.78) for anxiety disorders. Conclusions Elevated risk of eating disorders as well as of MDD, OCD, and anxiety disorders was found in international adoptees. A parallel pattern between AN and OCD was observed, which both display less elevated rates than the other diagnoses. A considerable number of biological, environmental, and societal factors have been suggested to explain the observed differences in mental health between adoptees and non-adoptees, but they remain primarily theoretical.

中文翻译：

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国际收养者饮食失调的风险：一项使用瑞典国家人口登记册的队列研究

目的 与一般人群相比，被收养者更常被转诊至专科精神科治疗，表现出更高的自杀风险，并表现出更多的注意力缺陷/多动障碍症状。然而，关于被收养者对患饮食失调风险的影响知之甚少。本研究的目的是评估国际收养者的饮食失调风险是否高于瑞典本土人。方法 在本回顾性队列研究中，来自瑞典总人口登记册的 1979 年至 2005 年间出生的个人的数据用于评估是否居住在瑞典的国际收养者（n= 25 287) 患神经性厌食症 (AN) 和其他饮食失调 (OED) 的风险高于普通人群中父母为瑞典出生的非收养者 (n= 2 046 835）。将这些结果的模式与重度抑郁症 (MDD)、强迫症 (OCD) 和焦虑症的模式进行比较，以确定观察到的任何影响是否是饮食失调所独有的，或者反映了对心理健康结果的更普遍影响。结果 调整相关人口学协变量的生存分析显示，国际收养者中所有检查过的精神疾病的风险升高：AN 的风险比（95% 置信区间）为 1.21（1.04-1.41），OED 为 1.60（1.44-1.79），1.90 MDD 为 (1.81–2.00)，强迫症为 1.25 (1.09–1.44)，焦虑症为 1.69 (1.60–1.78)。结论 在国际收养者中发现进食障碍以及 MDD、OCD 和焦虑症的风险升高。观察到 AN 和 OCD 之间的平行模式，两者都显示出比其他诊断低的升高率。已经提出了大量的生物、环境和社会因素来解释被收养者和非被收养者之间观察到的心理健康差异，但它们仍然主要是理论上的。