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Merino D, Gérard AO, Destere A, Askenazy F, Dor E, Benoit M, Cherikh F, Drici MD. Iatrogenic triggers for anorexia nervosa and bulimia nervosa: A WHO safety database disproportionality analysis. Psychiatry Res 2023; 327:115415. [PMID: 37611327 DOI: 10.1016/j.psychres.2023.115415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/31/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
Eating disorders, characterized by abnormal eating, weight control behaviors or both include anorexia nervosa (AN) and bulimia nervosa (BN). We investigated their potential iatrogenic triggers, using real-world data from the WHO safety database (VigiBase®). VigiBase® was queried for all AN and BN reports. The reports were classified as `pediatric' or `adult' according to age. Disproportionality analyses relied on the Information Component (IC), in which a 95% confidence interval lower-end positivity was required to suspect a signal. Our queries yielded 309 AN and 499 BN reports. Isotretinoin was disproportionately reported in pediatric AN (IC 3.6; [2.6-4.3]), adult AN (IC 3.1; [1.7-4.0]), and pediatric BN (IC 3.9; [3.0-4.7]). Lamivudine (IC 4.2; [3.2-4.9]), nevirapine (IC 3.7; [2.6-4.6]), and zidovudine (IC 3.4; [2.0-4.3]) had the highest ICs in adult AN. AN was associated with isotretinoin, anticonvulsants in minors, and antiretroviral drugs in adults. In adults, BN was related to psychotropic and hormonally active drugs. Before treatment initiation, an anamnesis should seek out mental health conditions, allowing the identification of patients at risk of developing or relapsing into AN or BN. In addition to misuse, the hypothesis of iatrogenic triggers for AN and BN should also be considered.
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Affiliation(s)
- Diane Merino
- Department of Psychiatry, University Hospital of Nice, Nice, France; Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France
| | - Alexandre Olivier Gérard
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France; Université Côte d'Azur Laboratory of Molecular Physio Medicine (LP2M), UMR 7370, CNRS, Nice, France
| | - Alexandre Destere
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France; Université Côte d'Azur, Inria, CNRS, Laboratoire J.A. Dieudonné, Maasai team, Nice, France
| | - Florence Askenazy
- Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval Nice, France; CoBTek Laboratory, Université Côte d'Azur, 06000 Nice, France
| | - Emmanuelle Dor
- Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval Nice, France; CoBTek Laboratory, Université Côte d'Azur, 06000 Nice, France
| | - Michel Benoit
- Department of Psychiatry, University Hospital of Nice, Nice, France
| | - Faredj Cherikh
- Department of Addiction, University Hospital of Nice, Nice, France
| | - Milou-Daniel Drici
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France.
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Escrivá-Martínez T, Galiana L, Herrero R, Rodríguez-Arias M, Fernández-Aranda F, Gearhardt AN, Baños RM. Food addiction and its relationship with other eating behaviours among Spanish university students. J Eat Disord 2023; 11:60. [PMID: 37046319 PMCID: PMC10100167 DOI: 10.1186/s40337-023-00772-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/14/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Food addiction (FA) is characterised by symptoms such as loss of control over food consumption, inability to reduce consumption despite the desire to do so, and continued consumption despite negative consequences. The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) is a widely used instrument to assess FA. OBJECTIVES To validate the Spanish mYFAS 2.0; to analyse the relationships between FA with other eating behaviours, sociodemographic variables, and Body Mass Index (BMI); and to test the eating-related variables that account for the variance in FA. METHODS The sample consisted of 400 university students (Mage = 24.16, SDage = 6.12; 51% female), who completed the mYFAS 2.0 and measures of eating-related constructs. RESULTS A confirmatory factor analysis (CFA) supported the one-factor structure of the mYFAS 2.0. The scale showed good internal consistency (α = .78), and good convergent validity with the mYFAS. FA was related to eating styles, binge eating, and bulimia. No differences in FA were observed between males and females, and there was no association between FA and BMI. In addition, younger participants scored higher on FA than older participants. The eating-related variables explain 54.7% of the variance in FA. CONCLUSIONS The mYFAS 2.0 is a valid and reliable scale to assess FA in the Spanish population. The positive and significant relationship of variables related to eating (eating styles, binge eating and bulimia) with FA was demonstrated. These variables were indicated by those at high risk of FA.
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Affiliation(s)
- Tamara Escrivá-Martínez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, 46010, Valencia, Spain.
- Polibienestar Research Institute, University of Valencia, 46022, Valencia, Spain.
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029, Madrid, Spain.
| | - Laura Galiana
- Department of Methodology for the Behavioural Sciences, Faculty of Psychology, University of Valencia, 46010, Valencia, Spain
| | - Rocío Herrero
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Psychology and Sociology, University of Zaragoza, 44003, Teruel, Spain
| | - Marta Rodríguez-Arias
- Department of Psychobiology, Faculty of Psychology, University of Valencia, 46010, Valencia, Spain
| | - Fernando Fernández-Aranda
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, 530 Church St., Ann Arbor, MI, 48109, USA
| | - Rosa M Baños
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, 46010, Valencia, Spain
- Polibienestar Research Institute, University of Valencia, 46022, Valencia, Spain
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029, Madrid, Spain
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Keeler JL, Treasure J, Juruena MF, Kan C, Himmerich H. Reply to Skokou, M. Comment on “Keeler et al. Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review. Nutrients 2021, 13, 4158”. Nutrients 2022; 14:nu14102119. [PMID: 35631260 PMCID: PMC9146951 DOI: 10.3390/nu14102119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 04/27/2022] [Indexed: 12/07/2022] Open
Abstract
In response to our narrative review, which suggested the use of the glutamatergic n-methyl-D-aspartate (NMDA) receptor antagonist ketamine as a potential treatment for anorexia nervosa (AN) [...]
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Affiliation(s)
- Johanna Louise Keeler
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (J.T.); (H.H.)
- Correspondence: ; Tel.: +44-(0)-20-7848-0187
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (J.T.); (H.H.)
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK;
| | - Mario F. Juruena
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK;
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Carol Kan
- Eating Disorder Service, Central and North West London NHS Foundation Trust, 1 Nightingale Place, Kensington & Chelsea, London SW10 9NG, UK;
| | - Hubertus Himmerich
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (J.T.); (H.H.)
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK;
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Abstract
OBJECTIVE Binge eating, a core diagnostic symptom in binge eating disorder and bulimia nervosa, increases the risk of multiple physiological and psychiatric disorders. The neurotransmitter dopamine is involved in food craving, decision making, executive functioning, and impulsivity personality trait; all of which contribute to the development and maintenance of binge eating. The objective of this paper is to review the associations of dopamine levels/activities, dopamine regulator (e.g., dopamine transporter, degrading enzymes) levels/activities, and dopamine receptor availability/affinity with binge eating. METHODS A literature search was conducted in PubMed and PsycINFO to obtain human and animal studies published since 2010. RESULTS A total of 31 studies (25 human, six animal) were included. Among the human studies, there were 12 case-control studies, eight randomized controlled trials, and five cross-sectional studies. Studies used neuroimaging (e.g., positron emission tomography), genetic, and pharmacological (e.g., dopamine transporter inhibitor) techniques to describe or compare dopamine levels/activities, dopamine transporter levels/activities, dopamine degrading enzyme (e.g., catechol-O-methyltransferase) levels/activities, and dopamine receptor (e.g., D1, D2) availability/affinity among participants with and without binge eating. Most human and animal studies supported an altered dopaminergic state in binge eating (26/31, 83.9%); however, results were divergent regarding whether the altered state was hyperdopaminergic (9/26, 34.6%) or hypodopaminergic (17/26, 65.4%). The mixed findings may be partially explained by the variability in sample characteristics, study design, diagnosis criteria, and neuroimaging/genetic/pharmacological techniques used. However, it is possible that instead of being mutually exclusive, the hyperdopaminergic and hypodopaminergic state may co-exist, but in different stages of binge eating or in different individual genotypes. CONCLUSIONS For future studies to clarify the inconsistent findings, a homogenous sample that controls for confounders that may influence dopamine levels (e.g., psychiatric diseases) is preferable. Longitudinal studies are needed to evaluate whether the hyper- and hypo-dopaminergic states co-exist in different stages of binge eating or co-exist in individual phenotypes. Binge eating is characterized by eating a large amount of food in a short time and a feeling of difficulty to stop while eating. Binge eating is the defining symptom of binge eating disorder and bulimia nervosa, both of which are associated with serious health consequences. Studies have identified several psychological risk factors of binge eating, including a strong desire for food, impaired cognitive skills, and distinct personality traits (e.g., quick action without careful thinking). However, the physiological markers of binge eating remain unclear. Dopamine is a neurotransmitter that is heavily involved in feeding behavior, human motivation, cognitive ability, and personality. Therefore, dopamine is believed to play a critical role in binge eating. This review synthesized study findings related to the levels and activities of dopamine, dopamine regulators, and dopamine receptors in the context of binge eating. The primary finding is that most studies that used neuroimaging, genetic, or drug techniques found an altered dopaminergic state related to binge eating. However, the literature is inconsistent concerning the direction of the alteration. Considering the mixed findings and the limitations in study design, future studies, especially those that include repeated measurements, are needed to clarify the role of dopamine in binge eating.
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Affiliation(s)
- Yang Yu
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642 USA
| | - Renee Miller
- Brain and Cognitive Sciences, University of Rochester, 303F Meliora Hall, Rochester, NY 14627 USA
| | - Susan W. Groth
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642 USA
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Gay A, Cabe J, De Chazeron I, Lambert C, Defour M, Bhoowabul V, Charpeaud T, Tremey A, Llorca PM, Pereira B, Brousse G. Repetitive Transcranial Magnetic Stimulation (rTMS) as a Promising Treatment for Craving in Stimulant Drugs and Behavioral Addiction: A Meta-Analysis. J Clin Med 2022; 11:624. [PMID: 35160085 PMCID: PMC8836499 DOI: 10.3390/jcm11030624] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 02/05/2023] Open
Abstract
Addiction is a mental disorder with limited available treatment options. The therapeutic potential of repetitive transcranial magnetic stimulation (rTMS) on it, by targeting craving in particular, has been explored with heterogenous results. This meta-analysis uses updated evidence to assess overall rTMS efficacy on craving, differential effects between addiction types clustered into three groups (depressant (alcohol, cannabis, opiate), stimulant (nicotine, cocaine, methamphetamine), and behavioral addiction (gambling, eating disorder)), and stimulation settings. Studies on substance use, gambling, and eating disorders are included, with unrestricted stimulation settings, by searching the PubMed, Embase, PsycINFO, and Cochrane databases up to 30 April 2020. A total of 34 eligible studies (42 units of analysis) were identified. Because of highly significant heterogeneity in primary results, a sensitivity analysis was performed on a remaining sample of 26 studies (30 units of analysis). Analyses performed using random effects model revealed a small effect size favoring active rTMS over shamTMS stimulation in the reduction in craving. We found a significant difference between addiction types, with a persistent small effect only for stimulant and behavioral groups. In these groups we found no difference between the different combinations of target and frequency of stimulation, but a significant correlation between number of sessions and craving reduction. In conclusion, efficacy of rTMS on craving in stimulant and behavioral addiction was highlighted, but recommendations on optimal stimulation settings and its clinical application await further research.
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Affiliation(s)
- Aurélia Gay
- University Department of Psychiatry and Addiction, CHU St-Etienne, CEDEX 2, 42055 Saint-Étienne, France; (M.D.); (V.B.)
- TAPE Laboratory, EA7423, Jean Monnet University, 42100 Saint-Étienne, France
| | - Julien Cabe
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (J.C.); (I.D.C.); (P.-M.L.); (G.B.)
| | - Ingrid De Chazeron
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (J.C.); (I.D.C.); (P.-M.L.); (G.B.)
| | - Céline Lambert
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.L.); (B.P.)
| | - Maxime Defour
- University Department of Psychiatry and Addiction, CHU St-Etienne, CEDEX 2, 42055 Saint-Étienne, France; (M.D.); (V.B.)
| | - Vikesh Bhoowabul
- University Department of Psychiatry and Addiction, CHU St-Etienne, CEDEX 2, 42055 Saint-Étienne, France; (M.D.); (V.B.)
| | - Thomas Charpeaud
- Service d’Addictologie et Pathologies Duelles, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (T.C.); (A.T.)
| | - Aurore Tremey
- Service d’Addictologie et Pathologies Duelles, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (T.C.); (A.T.)
| | - Pierre-Michel Llorca
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (J.C.); (I.D.C.); (P.-M.L.); (G.B.)
| | - Bruno Pereira
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.L.); (B.P.)
| | - Georges Brousse
- Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (J.C.); (I.D.C.); (P.-M.L.); (G.B.)
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Post-traumatic stress disorder may set the neurobiological stage for eating disorders: A focus on glutamatergic dysfunction. Appetite 2021; 167:105599. [PMID: 34271078 DOI: 10.1016/j.appet.2021.105599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 06/23/2021] [Accepted: 07/12/2021] [Indexed: 12/30/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a trauma and stress-related disorder which has been shown to be highly comorbid with, and commonly a precedent of, the eating disorders anorexia nervosa, bulimia nervosa, and binge eating disorder. The objective of this review is to discuss a potential overlapping neurobiological mechanism for this comorbidity. Alterations in glutamatergic neurotransmission have been observed in all four of the aforementioned disorders. Excessive excitation via glutamate contributes to excitotoxicity, and over-activation of the hypothalamic-pituitary-adrenal axis, both of which have implications for the deterioration of various brain structures. Prominent structures impacted include the hippocampus, hypothalamus, and prefrontal cortex, all of which are integral to the regulation of stress and eating. The current review suggests that altered glutamate function by trauma or extreme stress may facilitate PTSD and subsequent eating disorder onset, and that glutamatergic modulation may be a key treatment for individuals suffering from these conditions. This overlapping mechanism may help inform future research on individuals with comorbid PTSD and eating disorders, and it could also help inform ways to potentially prevent the onset of these conditions.
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Nall RW, Heinsbroek JA, Nentwig TB, Kalivas PW, Bobadilla AC. Circuit selectivity in drug versus natural reward seeking behaviors. J Neurochem 2021; 157:1450-1472. [PMID: 33420731 PMCID: PMC8178159 DOI: 10.1111/jnc.15297] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/16/2020] [Accepted: 01/03/2021] [Indexed: 12/23/2022]
Abstract
Substance use disorder (SUD) is characterized, in part by behavior biased toward drug use and away from natural sources of reward (e.g., social interaction, food, sex). The neurobiological underpinnings of SUDs reveal distinct brain regions where neuronal activity is necessary for the manifestation of SUD-characteristic behaviors. Studies that specifically examine how these regions are involved in behaviors motivated by drug versus natural reward allow determinations of which regions are necessary for regulating seeking of both reward types, and appraisals of novel SUD therapies for off-target effects on behaviors motivated by natural reward. Here, we evaluate studies directly comparing regulatory roles for specific brain regions in drug versus natural reward. While it is clear that many regions drive behaviors motivated by all reward types, based on the literature reviewed we propose a set of interconnected regions that become necessary for behaviors motivated by drug, but not natural rewards. The circuitry is selectively necessary for drug seeking includes an Action/Reward subcircuit, comprising nucleus accumbens, ventral pallidum, and ventral tegmental area, a Prefrontal subcircuit comprising prelimbic, infralimbic, and insular cortices, a Stress subcircuit comprising the central nucleus of the amygdala and the bed nucleus of the stria terminalis, and a Diencephalon circuit including lateral hypothalamus. Evidence was mixed for nucleus accumbens shell, insular cortex, and ventral pallidum. Studies for all other brain nuclei reviewed supported a necessary role in regulating both drug and natural reward seeking. Finally, we discuss emerging strategies to further disambiguate the necessity of brain regions in drug- versus natural reward-associated behaviors.
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Affiliation(s)
- Rusty W. Nall
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - Jasper A. Heinsbroek
- Department of Anesthesiology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Todd B. Nentwig
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - Peter W. Kalivas
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
- These authors share senior authorship
| | - Ana-Clara Bobadilla
- School of Pharmacy, University of Wyoming, Laramie, WY, USA
- These authors share senior authorship
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Fructose and Uric Acid as Drivers of a Hyperactive Foraging Response: A Clue to Behavioral Disorders Associated with Impulsivity or Mania? EVOL HUM BEHAV 2021; 42:194-203. [PMID: 33994772 DOI: 10.1016/j.evolhumbehav.2020.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Several behavioral disorders, including attention deficit hyperactivity disorder (ADHD), bipolar disorder, and aggressive behaviors are linked with sugar intake and obesity. The reason(s) for this association has been unclear. Here we present a hypothesis supporting a role for fructose, a component of sugar and high fructose corn syrup (HFCS), and uric acid (a fructose metabolite), in increasing the risk for these behavioral disorders. Recent studies have shown that the reason fructose intake is strongly associated with development of metabolic syndrome is that fructose intake activates an evolutionary-based survival pathway that stimulates foraging behavior and the storage of energy as fat. While modest intake may aid animals that would like to store fat as a protective response from food shortage or starvation, we propose that high intake of sugar and HFCS causes a hyperactive foraging response that stimulates craving, impulsivity, risk taking and aggression that increases the risk for ADHD, bipolar disease and aggressive behavior. High glycemic carbohydrates and salty foods may also contribute as they can be converted to fructose in the body. Some studies suggest uric acid produced during fructose metabolism may mediate some of these effects. Chronic stimulation of the pathway could lead to desensitization of hedonic responses and induce depression. In conclusion, a hyperactive foraging response driven by high glycemic carbohydrates and sugars may contribute to affective disorders.
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Bobadilla AC, Dereschewitz E, Vaccaro L, Heinsbroek JA, Scofield MD, Kalivas PW. Cocaine and sucrose rewards recruit different seeking ensembles in the nucleus accumbens core. Mol Psychiatry 2020; 25:3150-3163. [PMID: 32985600 PMCID: PMC8532193 DOI: 10.1038/s41380-020-00888-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 09/07/2020] [Accepted: 09/14/2020] [Indexed: 11/09/2022]
Abstract
Poorly regulated reward seeking is a central feature of substance use disorder. Recent research shows that rewarding drug-related experiences induce synchronous activation of a discrete number of neurons in the nucleus accumbens that are causally linked to reward-related contexts. Here we comprehensively characterize the specific ensemble of neurons built through experience that are linked to seeking behavior. We additionally address the question of whether or not addictive drugs usurp the neuronal networks recruited by natural rewards by evaluating cocaine- and sucrose-associated ensembles within the same mouse. We used FosCreERT2/+/Ai14 transgenic mice to tag cells activated by and potentially encoding cocaine and sucrose seeking. We tagged ~1% of neurons in the core subregion of the accumbens (NAcore) activated during cue-induced seeking for cocaine or sucrose. The majority of tagged cells in the seeking ensembles were D1-MSNs, and specifically activated during seeking, not during extinction or when mice remained in the home cage. To compare different reward-specific ensembles within the same mouse, we used a dual cocaine and sucrose self-administration protocol allowing reward-specific seeking. Using this model, we found ~70% distinction between the cells constituting the cocaine- compared to the sucrose-seeking ensemble. Establishing that cocaine recruits an ensemble of NAcore neurons largely distinct from neurons recruited into an ensemble coding for sucrose seeking suggest a finely tuned specificity of ensembles. The findings allow further exploration of the mechanisms that transform reward-based positive reinforcement into maladaptive drug seeking.
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Affiliation(s)
- Ana-Clara Bobadilla
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA.
- School of Pharmacy, University of Wyoming, Laramie, WY, USA.
| | - Eric Dereschewitz
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - Lucio Vaccaro
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - Jasper A Heinsbroek
- Department of Anesthesiology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Michael D Scofield
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
- Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Peter W Kalivas
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA.
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Wiss D, Brewerton T. Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint. Nutrients 2020; 12:E2937. [PMID: 32992768 PMCID: PMC7600542 DOI: 10.3390/nu12102937] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023] Open
Abstract
Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate regarding the value of a food addiction "diagnosis" among those with eating disorders such as anorexia nervosa binge/purge-type, bulimia nervosa, and binge eating disorder. Much of the food addiction research in eating disorder populations has failed to account for dietary restraint, which can increase addiction-like eating behaviors and may even lead to false positives. Some have argued that the concept of food addiction does more harm than good by encouraging restrictive approaches to eating. Others have shown that a better understanding of the food addiction model can reduce stigma associated with obesity. What is lacking in the literature is a description of a more comprehensive approach to the assessment of food addiction. This should include consideration of dietary restraint, and the presence of symptoms of other psychiatric disorders (substance use, posttraumatic stress, depressive, anxiety, attention deficit hyperactivity) to guide treatments including nutrition interventions. The purpose of this review is to help clinicians identify the symptoms of food addiction (true positives, or "the signal") from the more classic eating pathology (true negatives, or "restraint") that can potentially elevate food addiction scores (false positives, or "the noise"). Three clinical vignettes are presented, designed to aid with the assessment process, case conceptualization, and treatment strategies. The review summarizes logical steps that clinicians can take to contextualize elevated food addiction scores, even when the use of validated research instruments is not practical.
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Affiliation(s)
- David Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90025, USA
| | - Timothy Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA;
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Abstract
Bulimia nervosa (BN) shares central features with substance-related and addictive disorders. The metabotropic glutamate receptor subtype 5 (mGlu5) plays an important role in addiction. Based on similarities between binge eating and substance-related and addictive disorders, we investigated mGlu5 in vivo in 15 female subjects with BN and 15 matched controls. We measured mGlu5 distribution volume ratio (DVR) with positron emission tomography (PET) using [11 C]ABP688. In BN mGlu5 DVR was higher in the anterior cingulate cortex (ACC), subgenual prefrontal cortex, and straight gyrus (p < 0.05). In BN, higher mGlu5 DVR in various brain regions, including ACC, pallidum, putamen, and caudate, positively correlated with "maturity fears" as assessed using the Eating Disorder Inventory-2 (p < 0.05). In BN and controls, smokers had globally decreased mGlu5 DVR. We present the first evidence for increased mGlu5 DVR in BN. Our findings suggest that pharmacological agents inhibiting mGlu5 might have a therapeutic potential in BN.
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Himmerich H, Hotopf M, Shetty H, Schmidt U, Treasure J, Hayes RD, Stewart R, Chang CK. Psychiatric comorbidity as a risk factor for the mortality of people with bulimia nervosa. Soc Psychiatry Psychiatr Epidemiol 2019; 54:813-821. [PMID: 30756148 DOI: 10.1007/s00127-019-01667-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 02/04/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Bulimia nervosa (BN) is associated with increased mortality. Frequent comorbidities of BN include substance use disorders, affective disorders and personality disorders (PD). These comorbidities may add an additional risk for mortality. METHODS We investigated the influence of these psychiatric comorbidities on all-cause mortality with demographic and socioeconomic factors considered as confounders over an observation period from January 2007 to March 2016 for 1501 people with BN using anonymised health records data from the South London and Maudsley NHS Foundation Trust (SLaM), retrieved through its Clinical Records Interactive Search (CRIS) data resource. Mortality was ascertained through monthly linkages to the nationwide tracing system administered by the Office for National Statistics (ONS). We used Cox proportional hazards regression to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Multivariable analyses were also performed to estimate effects when controlling for confounding of age, sex, ethnicity, borough, marital status and deprivation score. RESULTS A total of 18 patients with BN died during the observation period. The standardised mortality ratio (SMR) for our study cohort (against the population of England and Wales in 2012 as a standard) was 2.52 (95% CI 1.49-3.97). Cox regressions revealed significant associations of mortality with older age and male gender. Comorbid PD (HR: 3.36; 95% CI 1.05-10.73) was significantly associated with all-cause mortality, even after controlling for demographic and socioeconomic covariates. CONCLUSIONS These results highlight increased mortality in patients with BN and the importance of recognising and treating PDs in patients with BN.
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Affiliation(s)
- Hubertus Himmerich
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Hitesh Shetty
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Ulrike Schmidt
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Janet Treasure
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Richard D Hayes
- Department of Psychological Medicine, King's College London, London, UK
| | - Robert Stewart
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Chin-Kuo Chang
- Department of Psychological Medicine, King's College London, London, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
- Department of Health and Welfare, University of Taipei, No. 101, Sec. 2, Jhongcheng Rd, Shilin District, Taipei, 111, Taiwan.
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Jaššová K, Albrecht J, Čerešňáková S, Papežová H, Anders M. Repetitive transcranial magnetic stimulation significantly influences the eating behavior in depressive patients. Neuropsychiatr Dis Treat 2019; 15:2579-2586. [PMID: 31564883 PMCID: PMC6735625 DOI: 10.2147/ndt.s203486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 07/16/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Depressive syndrome is one of the most common of psychiatric diseases and is ranked as the largest single contributor to global disability. Depression worsens the treatment outcomes of comorbid conditions and is a predictor of an increased mortality rate. Frequent comorbidities accompanying depressive syndrome are eating disorders (ED). The novel brain stimulation technique termed repetitive transcranial magnetic stimulation (rTMS) has been developed as a clinical tool to treat depression. Simultaneously the effect of rTMS has been studied on ED. PURPOSE The aim of this study was to monitor the correlation between the improvement in depressive symptoms and changes in eating behavior after rTMS treatment, and potential possibility of the utilization of rTMS in the treatment of these frequent comorbid conditions. METHODS To map the change in eating behavior, this study follows the changes in answers 5 and 7 in the Zung Self-Rating Depression Scale. The patients were treated with high-frequency rTMS focused on the left dorsolateral prefrontal cortex. RESULTS We observed a significant change in both questions. At the same time, the change in both questions correlates with a variance in the overall depressive symptoms. CONCLUSION The rTMS treatment of depressive syndrome resulted in significant clinical improvements, including changes in eating behavior.
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Affiliation(s)
- Katarína Jaššová
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 2 121 08, Czech Republic
| | - Jakub Albrecht
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 2 121 08, Czech Republic
| | - Silvie Čerešňáková
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 2 121 08, Czech Republic
| | - Hana Papežová
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 2 121 08, Czech Republic
| | - Martin Anders
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 2 121 08, Czech Republic
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Wiss DA, Schellenberger M, Prelip ML. Registered Dietitian Nutritionists in Substance Use Disorder Treatment Centers. J Acad Nutr Diet 2018; 118:2217-2221. [DOI: 10.1016/j.jand.2017.08.113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Indexed: 02/06/2023]
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15
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Noye Tuplin EW, Lightfoot SHM, Holahan MR. Comparison of the Time-Dependent Changes in Immediate Early Gene Labeling and Spine Density Following Abstinence From Contingent or Non-contingent Chocolate Pellet Delivery. Front Behav Neurosci 2018; 12:144. [PMID: 30061817 PMCID: PMC6055009 DOI: 10.3389/fnbeh.2018.00144] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 06/25/2018] [Indexed: 12/23/2022] Open
Abstract
Rationale: Incubation of craving is a phenomenon whereby responding for cues associated with a reward increases over extended periods of abstinence. Both contingent and non-contingent behavioral designs have been used to study the incubation of craving phenomenon with differing results. The present study directly compares behavioral and neural changes following contingent or non-contingent administration of chocolate flavored pellets. Objective: The current study examined whether an incubation of craving response would be observed at the behavioral and neural levels following delays of abstinence from chocolate pellets in a contingent or non-contingent reinforcement design. Methods: Rats were trained for 10 days to bar press for chocolate pellets (contingent) or received chocolate pellets in a non-contingent design (classical conditioning). Groups were then subjected to abstinence from the reward for 24 h, 7, 14 or 28 days at which point they were tested for responding for reward associated cues. Following the test, brains from all rats were processed and assessed for c-Fos and FosB labeling as well as dendritic spine density in the nucleus accumbens (NAc). Results: Behavioral measures during the test (lever presses, food hopper entries and locomotor activity) revealed similar behavioral outcomes across all delays indicating the lack of an incubation of craving response on both the contingent and non-contingent designs. Overall, labeling of c-Fos in the NAc was lower for the non-contingent group compared to the operant-trained and food restricted control. Compared to the operant-trained and non-trained control groups, a significantly reduced FosB labeling was noted in the NAc of the classically conditioned groups across all abstinence periods. Spine density in the NAc was elevated in both the classically and operant conditioned compared to the food-restricted, non-trained controls. Conclusions: Chocolate pellet reward did not result in incubation of craving but did produce behavioral learning that was associated with increased spine density. This suggests that chocolate pellet administration results in long-term structural and functional changes that are present for at least 28 days following abstinence. Contingent and non-contingent administration resulted in differential immediate early gene labeling in the NAc, but the functional significance of this has yet to be elucidated.
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16
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Jáuregui-Lobera I, Martínez-Quiñones JV. Neuromodulation in eating disorders and obesity: a promising way of treatment? Neuropsychiatr Dis Treat 2018; 14:2817-2835. [PMID: 30464467 PMCID: PMC6208872 DOI: 10.2147/ndt.s180231] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Neuromodulation can affect the functioning of the central nervous system (CNS), and emotional/eating behavior is an exciting facet of that functioning. Therefore, it would be possible to offer an alternative (or complement) treatment to psychotropic medications and different psychological and nutritional approaches to both eating disorders (EDs) and obesity. Although there are a number of publications in these areas, a systematic review has not been conducted to date. Abstracts, letters, conference reports, dissertations, and reviews were excluded. Clinical trials and controlled human clinical trials were filtered and included in this study. Articles included were based on the population suffering from anorexia nervosa, bulimia nervosa, binge ED, overweight, and obesity. No restrictions were placed on the sample size. Only trials investigating the effect of neuromodulation by means of deep brain stimulation (DBS), transcranial direct current stimulation (tDCS), and transcranial magnetic stimulation (TMS) were included. The following databases were used to conduct the search: MEDLINE/ PubMed, PsycINFO, PsycArticles, and Cochrane (Search Trials, CENTRAL). Study selection was performed following the PRISMA process (PRISMA 2009 Checklist). The total number of participants in all the trials was 562 (DBS, 25; tDCS, 138; TMS, 399; range, 3-90; median, 23.5). As a result, 50% of the studies had samples of between 14 and 38 participants. Neuro-modulation in ED seems to have certain clinical potential, and therefore, this is a promising area for further research. Developments in ED neuromodulation will be linked to neuroimaging to identify potential stimulation targets and possible biomarkers of treatment response. To date, TMS and/or direct current stimulation (DCS) is not the first-line treatment yet, but it could become a preferred option of treatment in the future. Further studies should avoid small sample sizes and the use of different methodologies. Currently, neuromodulation techniques are in the experimental phase, and they are not an evidence-based treatment for ED.
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Affiliation(s)
- Ignacio Jáuregui-Lobera
- Department of Molecular Biology and Biochemical Engineering, University of Pablo de Olavide of Seville, Seville, Spain,
| | - José V Martínez-Quiñones
- Department of Neurosurgery, Mutua de Accidentes de Zaragoza (Servicio de Neurocirugía), Zaragoza, Spain
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17
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Le Q, Li Y, Hou W, Yan B, Yu X, Song H, Wang F, Ma L. Binge-Like Sucrose Self-Administration Experience Inhibits Cocaine and Sucrose Seeking Behavior in Offspring. Front Behav Neurosci 2017; 11:184. [PMID: 29021748 PMCID: PMC5623684 DOI: 10.3389/fnbeh.2017.00184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 09/15/2017] [Indexed: 11/13/2022] Open
Abstract
Recent studies show that emotional and environmental stimuli promote epigenetic inheritance and influence behavioral development in the subsequent generations. Caloric mal- and under-nutrition has been shown to cause metabolic disturbances in the subsequent generation, but the incentive properties of paternal binge-like eating in offspring is still unknown. Here we show that paternal sucrose self-administration experience could induce inter-generational decrease in both sucrose and cocaine-seeking behavior, and sucrose responding in F1 rats, but not F2, correlated with the performance of F0 rats in sucrose self-administration. Higher anxiety level and decreased cocaine sensitivity were observed in Sucrose F1 compared with Control F1, possibly contributing to the desensitization phenotype in cocaine and sucrose self-administration. Our study revealed that paternal binge-like sucrose consumption causes decrease in reward seeking and induces anxiety-like behavior in the F1 offspring.
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Affiliation(s)
- Qiumin Le
- State Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, China
| | - Yanqing Li
- State Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, China
| | - Weiqing Hou
- State Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, China
| | - Biao Yan
- State Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, China
| | - Xiangchen Yu
- State Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, China
| | - Haikun Song
- State Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, China
| | - Feifei Wang
- State Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, China
| | - Lan Ma
- State Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, China
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18
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del Pino-Gutiérrez A, Jiménez-Murcia S, Fernández-Aranda F, Agüera Z, Granero R, Hakansson A, Fagundo AB, Bolao F, Valdepérez A, Mestre-Bach G, Steward T, Penelo E, Moragas L, Aymamí N, Gómez-Peña M, Rigol-Cuadras A, Martín-Romera V, Menchón JM. The relevance of personality traits in impulsivity-related disorders: From substance use disorders and gambling disorder to bulimia nervosa. J Behav Addict 2017; 6:396-405. [PMID: 28838248 PMCID: PMC5700725 DOI: 10.1556/2006.6.2017.051] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background and aims The main aim of this study was to analyze and describe the clinical characteristics and shared personality traits in different impulsivity-compulsivity spectrum disorders: substance use disorders (SUD), gambling disorder (GD), and bulimia nervosa (BN). The specific aims were to compare personality differences among individuals with pure SUD, BN with and without SUD, and GD with and without SUD. In addition, we assessed the differential predictive capacity of clinical and personality variables in relation to diagnostic subtype. Methods The sample comprised 998 subjects diagnosed according to DSM-IV-TR criteria: 101 patients were diagnosed with SUD, 482 with GD, 359 with BN, 11 with GD + SUD, and 45 patients with BN + SUD. Various assessment instruments were administered, as well as other clinical measures, to evaluate their predictive capacity. Results Marked differences in personality traits were observed between groups. Novelty seeking, harm avoidance, self-directedness, cooperation, and self-transcendence best differentiated the groups. Notably, novelty seeking was significantly higher in the two dual pathology subgroups. Patients with dual pathology showed the most dysfunctional personality profiles. Discussion and conclusion Our results indicate the existence of shared dysfunctional personality traits among the groups studied, especially in novelty seeking and self-directedness.
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Affiliation(s)
- Amparo del Pino-Gutiérrez
- Department of Nursing in Public Health, Mental Health, and Maternal and Child Health, School of Nursing, University of Barcelona, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Corresponding authors: Susana Jiménez-Murcia, PhD; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, L’Hospitalet de Llobregat, Barcelona 08907, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail: ; Fernando Fernández-Aranda, PhD; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, L’Hospitalet de Llobregat, Barcelona 08907, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail:
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Corresponding authors: Susana Jiménez-Murcia, PhD; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, L’Hospitalet de Llobregat, Barcelona 08907, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail: ; Fernando Fernández-Aranda, PhD; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, L’Hospitalet de Llobregat, Barcelona 08907, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail:
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anders Hakansson
- Division of Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Ana B. Fagundo
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Ferran Bolao
- Department of Internal Medicine, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Ana Valdepérez
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Eva Penelo
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Assumpta Rigol-Cuadras
- Department of Nursing in Public Health, Mental Health, and Maternal and Child Health, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Virginia Martín-Romera
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,CIBER Salud Mental (CIBERSAM), Instituto Carlos III, Barcelona, Spain
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Hall SB, Brown NW, Humphries JR. Premature Termination From Outpatient Psychotherapy in a University-Based Counseling Center. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/21501378.2017.1302786] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sean B. Hall
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - J. Ryan Humphries
- Behavioral Health Crisis Center of Cobb Douglas Public Health, Marietta, GA, USA
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Abstract
Bulimia nervosa was first described in 1979 by British psychiatrist Gerald Russell as a "chronic phase of anorexia nervosa" in which patients overeat and then use compensatory mechanisms, such as self-induced vomiting, laxatives, or prolonged periods of starvation. The characterization of bulimia nervosa continues to evolve with the introduction of the DSM-5 in 2013. In this article, the epidemiology and risk factors of bulimia nervosa are identified and reviewed, along with the medical complications and psychiatric comorbidities. The evaluation of a patient with suspected bulimia nervosa is addressed, with an emphasis on acquiring a complete and thorough history as well as discovering any comorbidities that are present. Management of the patient involves both medical interventions and behavioral counseling in order to address physical, psychological, and social needs. Lastly, a new diagnosis introduced in the DSM-5, purging disorder, is described and discussed.
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Affiliation(s)
- Marigold Castillo
- Division of Adolescent Medicine, Cohen Children׳s Medical Center, Northwell Health, New Hyde Park, New York, Hofstra-Northwell School of Medicine, Hempstead, New York
| | - Eric Weiselberg
- Division of Adolescent Medicine, Cohen Children׳s Medical Center, Northwell Health, New Hyde Park, New York, Hofstra-Northwell School of Medicine, Hempstead, New York
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Gay A, Jaussent I, Sigaud T, Billard S, Attal J, Seneque M, Galusca B, Van Den Eynde F, Massoubre C, Courtet P, Guillaume S. A Lack of Clinical Effect of High-frequency rTMS to Dorsolateral Prefrontal Cortex on Bulimic Symptoms: A Randomised, Double-blind Trial. EUROPEAN EATING DISORDERS REVIEW 2016; 24:474-481. [DOI: 10.1002/erv.2475] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/12/2016] [Accepted: 08/11/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Aurelia Gay
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | | | - Torrance Sigaud
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | - Stephane Billard
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
| | - Jerome Attal
- Inserm U1061; University of Montpellier; Montpellier France
- University Department of Adult Psychiatry; CHRU Montpellier; Montpellier France
| | - Maude Seneque
- Inserm U1061; University of Montpellier; Montpellier France
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital; CHRU Montpellier; Montpellier France
| | - Bogdan Galusca
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | - Frederique Van Den Eynde
- Eating Disorders Program, Department of Psychiatry, Douglas Hospital; McGill University; Montreal Canada
| | - Catherine Massoubre
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | - Philippe Courtet
- Inserm U1061; University of Montpellier; Montpellier France
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital; CHRU Montpellier; Montpellier France
| | - Sebastien Guillaume
- Inserm U1061; University of Montpellier; Montpellier France
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital; CHRU Montpellier; Montpellier France
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22
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Beitscher-Campbell H, Blum K, Febo M, Madigan MA, Giordano J, Badgaiyan RD, Braverman ER, Dushaj K, Li M, Gold MS. Pilot clinical observations between food and drug seeking derived from fifty cases attending an eating disorder clinic. J Behav Addict 2016; 5:533-41. [PMID: 27502054 PMCID: PMC5264422 DOI: 10.1556/2006.5.2016.055] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background The reward deficiency syndrome hypothesis posits that genes are responsible for reward dependence and related behaviors. There is evidence that both bulimia and anorexia nervosa, especially in women, have been linked to a lifetime history of substance use disorder (SUD). There are difficulties in accepting food as an addiction similar to drugs; however, increasingly neuroimaging studies favor such an assertion. Case presentations We are reporting the evidence of comorbidity of eating disorders with SUD found within these case presentations. We show 50 case reports derived from two independent treatment centers in Florida that suggest the commonality between food and drug addictions. In an attempt to provide data from this cohort, many participants did not adequately respond to our questionnaire. Discussion We propose that dopamine agonist therapy may be of common benefit. Failure in the past may reside in too powerful D2 agonist activity leading to D2 receptor downregulation, while the new methodology may cause a reduction of "dopamine resistance" by inducing "dopamine homeostasis." While this is not a definitive study, it does provide some additional clinical evidence that these two addictions are not mutually exclusive. Conclusion Certainly, it is our position that there is an overlap between food- and drug-seeking behavior. We propose that the studies focused on an effort to produce natural activation of dopaminergic reward circuitry as a type of common therapy may certainly be reasonable. Additional research is warranted.
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Affiliation(s)
- Harriet Beitscher-Campbell
- A New Beginning PA, North Miami Beach, FL, USA,Ocean Breeze Recovery Program, Pompano Beach, FL, USA,National Institute of Holistic Addiction Studies, North Miami Beach, FL, USA
| | - Kenneth Blum
- National Institute of Holistic Addiction Studies, North Miami Beach, FL, USA,Department of Psychiatry, McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA,Division of Neuroscience-based Therapy, Summit Estate Recovery Center, Las Gatos, CA, USA,Department of Psychiatry, The University of Vermont, Burlington, VT, USA,Department of Neurological Research, PATH Foundation NY, New York, NY, USA,Dominion Diagnostics, LLC, North Kingstown, RI, USA,IGENE, LLC, Austin, TX, USA,Department of Psychiatry and Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA,Division of Neuroscience Research and Addiction Therapy, The Shores Treatment and Recovery, Port Saint Lucie, FL, USA,Institute of Psychology, Eötvös Loránd University, Budapest, Hungary,Corresponding author: Kenneth Blum, PhD; Department of Psychiatry, University of Florida, Box 100183, Gainesville, FL 32610-0183, USA; Phone: +1 352 392 6680; Fax: +1 352 392 8217; E-mail:
| | - Marcelo Febo
- Department of Psychiatry, McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
| | | | - John Giordano
- National Institute of Holistic Addiction Studies, North Miami Beach, FL, USA
| | - Rajendra D. Badgaiyan
- Department of Psychiatry and Laboratory for Radiochemistry, University of Minnesota, Minneapolis, MN, USA
| | - Eric R. Braverman
- Department of Neurological Research, PATH Foundation NY, New York, NY, USA
| | - Kristina Dushaj
- Department of Neurological Research, PATH Foundation NY, New York, NY, USA
| | - Mona Li
- Department of Neurological Research, PATH Foundation NY, New York, NY, USA
| | - Mark S. Gold
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA,Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Patrono E, Di Segni M, Patella L, Andolina D, Valzania A, Latagliata EC, Felsani A, Pompili A, Gasbarri A, Puglisi-Allegra S, Ventura R. When chocolate seeking becomes compulsion: gene-environment interplay. PLoS One 2015; 10:e0120191. [PMID: 25781028 PMCID: PMC4363151 DOI: 10.1371/journal.pone.0120191] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 02/04/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Eating disorders appear to be caused by a complex interaction between environmental and genetic factors, and compulsive eating in response to adverse circumstances characterizes many eating disorders. MATERIALS AND METHODS We compared compulsion-like eating in the form of conditioned suppression of palatable food-seeking in adverse situations in stressed C57BL/6J and DBA/2J mice, two well-characterized inbred strains, to determine the influence of gene-environment interplay on this behavioral phenotype. Moreover, we tested the hypothesis that low accumbal D2 receptor (R) availability is a genetic risk factor of food compulsion-like behavior and that environmental conditions that induce compulsive eating alter D2R expression in the striatum. To this end, we measured D1R and D2R expression in the striatum and D1R, D2R and α1R levels in the medial prefrontal cortex, respectively, by western blot. RESULTS Exposure to environmental conditions induces compulsion-like eating behavior, depending on genetic background. This behavioral pattern is linked to decreased availability of accumbal D2R. Moreover, exposure to certain environmental conditions upregulates D2R and downregulates α1R in the striatum and medial prefrontal cortex, respectively, of compulsive animals. These findings confirm the function of gene-environment interplay in the manifestation of compulsive eating and support the hypothesis that low accumbal D2R availability is a "constitutive" genetic risk factor for compulsion-like eating behavior. Finally, D2R upregulation and α1R downregulation in the striatum and medial prefrontal cortex, respectively, are potential neuroadaptive responses that parallel the shift from motivated to compulsive eating.
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Affiliation(s)
- Enrico Patrono
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, Coppito, Italy
| | - Matteo Di Segni
- Santa Lucia Foundation, Rome, Italy
- Department of Psychology and Center “Daniel Bovet,” Sapienza University, Rome, Italy
| | - Loris Patella
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, Coppito, Italy
| | - Diego Andolina
- Santa Lucia Foundation, Rome, Italy
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, Coppito, Italy
| | - Alessandro Valzania
- Santa Lucia Foundation, Rome, Italy
- Department of Psychology and Center “Daniel Bovet,” Sapienza University, Rome, Italy
| | - Emanuele Claudio Latagliata
- Santa Lucia Foundation, Rome, Italy
- Department of Psychology and Center “Daniel Bovet,” Sapienza University, Rome, Italy
| | - Armando Felsani
- CNR, Institute of Cellular Biology and Neurobiology, Rome, Italy
| | - Assunta Pompili
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, Coppito, Italy
| | - Antonella Gasbarri
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, Coppito, Italy
| | - Stefano Puglisi-Allegra
- Santa Lucia Foundation, Rome, Italy
- Department of Psychology and Center “Daniel Bovet,” Sapienza University, Rome, Italy
| | - Rossella Ventura
- Santa Lucia Foundation, Rome, Italy
- Department of Psychology and Center “Daniel Bovet,” Sapienza University, Rome, Italy
- * E-mail:
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Cocaine-induced locomotor activity in rats selectively bred for low and high voluntary running behavior. Psychopharmacology (Berl) 2015; 232:673-81. [PMID: 25106389 DOI: 10.1007/s00213-014-3698-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 07/28/2014] [Indexed: 02/06/2023]
Abstract
RATIONALE The rewarding effects of physical activity and abused drugs are caused by stimulation of similar brain pathways. Low (LVR) and high (HVR) voluntary running lines were developed by selectively breeding Wistar rats on running distance performance on postnatal days 28-34. We hypothesized that LVR rats would be more sensitive to the locomotor-activating effects of cocaine than HVR rats due to their lower motivation for wheel running. OBJECTIVES We investigated how selection for LVR or HVR behavior affects inherited activity responses: (a) open field activity levels, (b) habituation to an open field environment, and (c) the locomotor response to cocaine. METHODS Open field activity was measured for 80 min on three successive days (days 1-3). Data from the first 20 min were analyzed to determine novelty-induced locomotor activity (day 1) and the habituation to the environment (days 1-3). On day 3, rats were acclimated to the chamber for 20 min and then received saline or cocaine (10, 20, or 30 mg/kg) injection. Dopamine transporter (DAT) protein in the nucleus accumbens was measured via Western blot. RESULTS Selecting for low and high voluntary running behavior co-selects for differences in inherent (HVR > LVR) and cocaine-induced (LVR > HVR) locomotor activity levels. The differences in the selected behavioral measures do not appear to correlate with DAT protein levels. CONCLUSIONS LVR and HVR rats are an intriguing physical activity model for studying the interactions between genes related to the motivation to run, to use drugs of abuse, and to exhibit locomotor activity.
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Weibel S, Lalanne L, Riegert M, Bertschy G. Efficacy of High-Dose Baclofen for Alcohol Use Disorder and Comorbid Bulimia: A Case Report. J Dual Diagn 2015; 11:203-4. [PMID: 26457456 DOI: 10.1080/15504263.2015.1104483] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
High-dose baclofen is a promising treatment for alcohol use disorder, with a specific action on craving. A more general action on craving in other addictive disorders has been suggested based on the hypothesis of a common neurobiological pathway in addictions. We report the case of a woman with both alcohol use disorder and bulimia nervosa. There was a positive response to high-dose baclofen on alcohol craving, but no response on food craving. The case illustrates that craving could be differentially responsive to anti-craving drugs.
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Affiliation(s)
- Sébastien Weibel
- a Department of Psychiatry and Mental Health , Strasbourg University Hospital , Strasbourg , France.,b INSERM Unit 1114 , Strasbourg , France
| | - Laurence Lalanne
- a Department of Psychiatry and Mental Health , Strasbourg University Hospital , Strasbourg , France.,b INSERM Unit 1114 , Strasbourg , France
| | - Myriam Riegert
- a Department of Psychiatry and Mental Health , Strasbourg University Hospital , Strasbourg , France
| | - Gilles Bertschy
- a Department of Psychiatry and Mental Health , Strasbourg University Hospital , Strasbourg , France.,b INSERM Unit 1114 , Strasbourg , France.,c Translational Medicine Federation, Medical School, Strasbourg University , Strasbourg , France
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Di Segni M, Patrono E, Patella L, Puglisi-Allegra S, Ventura R. Animal models of compulsive eating behavior. Nutrients 2014; 6:4591-609. [PMID: 25340369 PMCID: PMC4210935 DOI: 10.3390/nu6104591] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/07/2014] [Accepted: 10/10/2014] [Indexed: 01/20/2023] Open
Abstract
Eating disorders are multifactorial conditions that can involve a combination of genetic, metabolic, environmental, and behavioral factors. Studies in humans and laboratory animals show that eating can also be regulated by factors unrelated to metabolic control. Several studies suggest a link between stress, access to highly palatable food, and eating disorders. Eating "comfort foods" in response to a negative emotional state, for example, suggests that some individuals overeat to self-medicate. Clinical data suggest that some individuals may develop addiction-like behaviors from consuming palatable foods. Based on this observation, "food addiction" has emerged as an area of intense scientific research. A growing body of evidence suggests that some aspects of food addiction, such as compulsive eating behavior, can be modeled in animals. Moreover, several areas of the brain, including various neurotransmitter systems, are involved in the reinforcement effects of both food and drugs, suggesting that natural and pharmacological stimuli activate similar neural systems. In addition, several recent studies have identified a putative connection between neural circuits activated in the seeking and intake of both palatable food and drugs. The development of well-characterized animal models will increase our understanding of the etiological factors of food addiction and will help identify the neural substrates involved in eating disorders such as compulsive overeating. Such models will facilitate the development and validation of targeted pharmacological therapies.
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Affiliation(s)
- Matteo Di Segni
- Dipartimento di Psicologia and Centro "Daniel Bovet", Sapienza-Università di Roma, Piazzale Aldo Moro 5, 00181 Roma, Italy.
| | - Enrico Patrono
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, University of L'Aquila, via Vetoio (Coppito 2) Coppito, 67010 L'Aquila, Italy.
| | - Loris Patella
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, University of L'Aquila, via Vetoio (Coppito 2) Coppito, 67010 L'Aquila, Italy.
| | - Stefano Puglisi-Allegra
- Dipartimento di Psicologia and Centro "Daniel Bovet", Sapienza-Università di Roma, Piazzale Aldo Moro 5, 00181 Roma, Italy.
| | - Rossella Ventura
- Dipartimento di Psicologia and Centro "Daniel Bovet", Sapienza-Università di Roma, Piazzale Aldo Moro 5, 00181 Roma, Italy.
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Meule A, von Rezori V, Blechert J. Food Addiction and Bulimia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2014; 22:331-7. [DOI: 10.1002/erv.2306] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 05/22/2014] [Accepted: 06/10/2014] [Indexed: 12/20/2022]
Affiliation(s)
- Adrian Meule
- Institute of Psychology, Department of Psychology I; University of Würzburg; Germany
- Hospital for Child and Adolescent Psychiatry; LWL University Hospital Hamm of the Ruhr University Bochum; Germany
| | - Vittoria von Rezori
- Division of Clinical Psychology, Psychotherapy and Health Psychology; University of Salzburg; Austria
| | - Jens Blechert
- Division of Clinical Psychology, Psychotherapy and Health Psychology; University of Salzburg; Austria
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