Patients with anorexia nervosa perceive higher emotional connectedness to their parents than bulimia nervosa patients independent of objective family factors

Summary Background Psychological constructs of individual autonomy (IA) and emotional connectedness (EC) differ between patients with anorexia nervosa (AN) and bulimia nervosa (BN); however, it is unclear whether objective family factors modulate these associations. Methods In a cohort of 445 participants from the FamFINED study (FAMily Factors INvolved in Eating Disorders) with eating disorders (EDs) diagnosed as AN ( n = 232) or BN ( n = 213), we assessed objective psychosocial family factors as well as the IA and EC constructs using the self-rated Subjective Family Image Test (SFIT) questionnaire. Results While the two ED entities did not differ with respect to IA in univariate analysis ( p = 0.355), patients diagnosed with AN had higher perceived EC than participants with BN, as assessed by a lower score for the difference between the actual and desired family image (16.0 ± 15.8 vs. 21.6 ± 17.6, p < 0.001). In a regression model adjusted for age, body-mass index, living in parental home, and parental separation, we found that the EC score used as the dependent variable differed significantly between the two ED entities (expβ = 4.8, 95% confidence interval = 0.54–9.11, p = 0.028). In contrast, no association was observed between IA and ED diagnoses using the same set of confounders ( p = 0.717). Conclusion The higher perceived EC in AN patients compared to those diagnosed with BN indicates more intense feelings of family solidarity, regardless of objective family factors.