Eating disorders (EDs) commonly co-occur with other psychiatric and neurodevelopmental disorders including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD); however, the pattern of family history and genetic overlap among them requires clarification. This study investigated the diagnostic, familial, and genetic associations of EDs with ADHD and ASD. The nationwide population-based cohort study included all individuals born in Denmark, 1981–2008, linked to their siblings and cousins. Cox regression was used to estimate associations between EDs and ADHD or ASD, and mediation analysis was used to assess the effects of intermediate mood or anxiety disorders. Polygenic scores (PGSs) were used to investigate the genetic association between anorexia nervosa (AN) and ADHD or ASD. Significantly increased risk for any ED was observed following an ADHD or ASD diagnosis. Mediation analysis suggested that intermediate mood or anxiety disorders could account for 44%–100% of the association between ADHD or ASD and ED. Individuals with a full sibling or maternal half sibling with ASD had increased risk of AN compared to those with siblings without ASD. A positive association was found between ASD-PGS and AN risk whereas a negative association was found between AN-PGS and ADHD. In this study, positive phenotypic associations between EDs and ADHD or ASD, mediation by mood or anxiety disorder, and genetic associations between ASD-PGS and AN and between AN-PGS and ADHD were observed. These findings could guide future research in the development of new treatments that can mitigate the development of EDs among individuals with ADHD or ASD.

进食障碍 （ED） 通常与其他精神和神经发育障碍同时发生，包括注意力缺陷/多动障碍 （ADHD） 和自闭症谱系障碍 （ASD）;然而，他们之间的家族史模式和遗传重叠需要澄清。本研究调查了 ED 与 ADHD 和 ASD 的诊断、家族和遗传关联。这项全国性的基于人群的队列研究包括 1981 年至 2008 年在丹麦出生的所有与他们的兄弟姐妹和堂兄弟姐妹有关的人。Cox 回归用于估计 EDs 与 ADHD 或 ASD 之间的关联，中介分析用于评估中间情绪或焦虑障碍的影响。多基因评分 （PGS） 用于研究神经性厌食症 （AN） 与 ADHD 或 ASD 之间的遗传关联。在 ADHD 或 ASD 诊断后观察到任何 ED 的风险显着增加。中介分析表明，中间情绪或焦虑障碍可能占 ADHD 或 ASD 与 ED 之间关联的 44%-100%。与没有 ASD 的兄弟姐妹或同父异母兄弟姐妹相比，患有 ASD 的个体患 AN 的风险增加。发现 ASD-PGS 与 AN 风险之间存在正相关，而 AN-PGS 与 ADHD 之间存在负相关。在这项研究中，观察到 EDs 与 ADHD 或 ASD 之间的正表型关联、情绪或焦虑障碍的介导以及 ASD-PGS 和 AN 之间以及 AN-PGS 和 ADHD 之间的遗传关联。这些发现可以指导未来的研究，以开发新的治疗方法，以减轻 ADHD 或 ASD 患者 EDs 的发展。