Depression and Eating Pathology in Youth: An Analysis of Ethnicity

Background: Depression has been linked to an increased risk of eating pathology, yet few studies have examined this association in ethnic minority youth.

Methods: The National Youth Risk Behavior Surveillance Survey (YRBSS) is an annual survey administered to adolescents that examines depression, purging, and fasting behaviors. Analyses were conducted with 11,523 participants of the 2007 cohort. All analyses used ethnicity-stratified models: (1) Caucasian, (2) Asian/Pacific Islander (3) African American, (4) Multiple Non-Hispanic/American Indian, (5) Hispanic, and (6) Multiple Hispanic. Outcomes were examined using logistic regression controlling for socio-demographics, body mass index, and interpersonal violence.

Results: In the adjusted model, Caucasian youth were five times (OR = 5.28,95% CI:3.83-7.29) and Multiple Non-Hispanic/American Indian youth were four times (OR= 4.34, 95% CI:1.80 -10.46) as likely to vomit if depressed, while African Americans were 1.83 (95% CI:1.08-3.12) times as likely, Hispanics were 1.93 (95% CI:1.14-3.26) times as likely and Multiple Hispanics were 2.68 (95% CI:1.62-4.43) times as likely. No association was found in Asian/Pacific Islander youth (OR: 1.46, 95%CI: 0.38-5.57).

Multiple Non-Hispanics/American Indians (OR= 4.41,95% CI: 2.56-7.58), Caucasians (OR= 3.64,95% CI: 3.00-4.42) and Hispanics (OR= 3.56,95% CI:2.52-5.03) were at increased risk for fasting behaviors if depressed while Multiple Hispanics (OR= 2.99, 95% CI:2.19-4.09), Asians/Pacific Islanders (OR=2.71, 95% CI:1.15-6.37), and African Americans (OR=2.70, 95% CI:2.05-3.57) were at lesser risk.

Conclusions: The increased risk for eating pathology in certain ethnicities raises questions as to why they are vulnerable when depressed. Future research is needed to explore reasons for these heightened vulnerabilities among ethnic youth.