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Tuncer GZ, Çetinkaya Duman Z. Effects of Shared Decision Making Model-Based Guided Self-Help Program on Emotional Eating and Uncontrolled Eating Behavior in Individuals with a Severe Mental Disorder: A Randomized Controlled Trial. Issues Ment Health Nurs 2024; 45:331-343. [PMID: 38412065 DOI: 10.1080/01612840.2023.2297310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE The study was aimed at determining the effectiveness of the Shared Decision Making Model-based Guided Self-Help Program (SDM-GSH) on emotional eating behavior and uncontrolled eating behavior in individuals with a severe mental disorder. METHOD This randomized controlled experimental study was conducted in the Community Mental Health Center of a university hospital between September 2020 and November 2022. The sample of the study consisted of 64 participants. Of them, 33 were in the Experimental Group and 31 were in the control group. To collect the study data, the Patient Information Form, Emotional Eater Questionnaire, and Three-Factor Eating Questionnaire were administered. The participants in the Experimental Group took part in the SDM-GSH. The study data were collected from the participants in the Experimental and Control Groups before, right after and 6 months after the intervention. RESULTS The comparison of the BMI values of the participants with a severe mental disorder who took part in the SDM-GSH demonstrated that their pre-intervention BMI values significantly decreased at the measurements preformed right after and 6 months after the intervention (p < 0.05). The mean emotional eating (λ = 0.189, η2 = 0.811) and uncontrolled eating (λ = 0.218, η2 = 0.782) scores obtained by the participants in the Experimental Group before the intervention significantly decreased at the measurements preformed right after and 6 months after the intervention (p < 0.05). CONCLUSION Based on the results of our study, it is concluded that the SDM-GSH positively affected the BMI values, emotional eating behaviors and uncontrolled eating behaviors of the participants with a severe mental disorder.
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Affiliation(s)
- Gülsüm Zekiye Tuncer
- Department of Psychiatric Nursing, Dokuz Eylül University Institute of Health Sciences, Izmir, Turkey
| | - Zekiye Çetinkaya Duman
- Department of Psychiatric Nursing, Dokuz Eylül University Faculty of Nursing, Izmir, Turkey
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Aylward L, Lilly C, Tabone L, Szoka N, Abunnaja S, Cox S. Anxiety Predicts Reduced Weight Loss 30 Months after Bariatric Surgery. Surg Obes Relat Dis 2022; 18:919-927. [DOI: 10.1016/j.soard.2022.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
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Lim MC, Parsons S, Goglio A, Fox E. Anxiety, stress, and binge eating tendencies in adolescence: a prospective approach. J Eat Disord 2021; 9:94. [PMID: 34344454 PMCID: PMC8330038 DOI: 10.1186/s40337-021-00444-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Recent years have witnessed an increasing prevalence of binge eating tendencies in adolescence-warranting a clearer understanding of their underlying predisposing and precipitating factors. The current study investigated whether the interaction between high levels of anxiety and stress predicted increased levels of binge eating tendencies in a prospective cohort of adolescents (N = 324). METHODS Measurements were taken over three waves (M ages: 13.33, 14.48, 15.65) as part of the CogBIAS Longitudinal Study. Longitudinal associations between levels of anxiety and stress with binge eating tendencies were estimated using a random intercept cross-lagged panel model (RI-CLPM), which calculates within-person fluctuations over time while accounting for individual trait-like stability and between-person variations. Binge eating tendencies were measured by the Cognitive Restraint, Uncontrolled Eating, and Emotional Eating styles from the Three-Factor Eating Questionnaire-R18. Two models were created for each binge eating tendencies variable: (1) a basic model with anxiety and stress as independent variables; (2) an interaction model with an additional anxiety*stress interaction term. Model fit was assessed by SEM fit indices: X2, CFI, NFI, TLI, RMSEA, SRMR. Superior model fit was ascertained by a chi-square difference test (p < .05). RESULTS For Cognitive Restraint, the interaction model demonstrated superior fit to the data (p < .05). The anxiety*stress interaction at Waves 1 and 2 was significantly negatively associated with Cognitive Restraint at Waves 2 (β = -0.18, p = .002) and 3 (β = -0.14, p = .002)-suggesting that anxiety and stress interacted to predict increased binge eating tendencies linked with cognitive restraint over and above their independent effects. In contrast, the interaction term between anxiety*stress did not predict levels of Uncontrolled Eating or Emotional Eating over time. CONCLUSIONS The results highlight the importance of increasing awareness of the interaction between concurrently high anxiety and stress as a potential risk factor for binge eating tendencies in young people. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Michele C Lim
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
| | - Sam Parsons
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Alessia Goglio
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Elaine Fox
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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Nakamura Y, Koike S. Association of Disinhibited Eating and Trait of Impulsivity With Insula and Amygdala Responses to Palatable Liquid Consumption. Front Syst Neurosci 2021; 15:647143. [PMID: 34012386 PMCID: PMC8128107 DOI: 10.3389/fnsys.2021.647143] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/09/2021] [Indexed: 12/31/2022] Open
Abstract
Eating behavior is not only influenced by the current energy balance, but also by the behavioral characteristics of eating. One of the recognized eating behavior constructs is ‘disinhibited eating,’ which refers to the tendency to overeat in response to negative emotional states or the presence of highly palatable foods. Food-related disinhibition is involved in binge eating, weight gain, and obesity and is also associated with the trait of impulsivity, which in turn, is linked to weight gain or maladaptive eating. However, the relationships among food-related disinhibition, the trait of impulsivity, and the neural substrates of eating behaviors in adolescence remain unclear. Therefore, we designed a functional magnetic resonance imaging (fMRI) study to examine the associations between brain responses to palatable liquid consumption and disinhibited eating behavior or impulsivity in healthy adolescents. Thirty-four adolescents (mean age ± standard deviation = 17.12 ± 1.91 years, age range = 14–19 years, boys = 15, girls = 19) participated in this study. Disinhibited eating was assessed with the disinhibition subscale of the Three-Factor Eating Questionnaire, while impulsivity was assessed using the Barratt impulsiveness scale. Participants received two fMRI sessions−a palatable liquid consumption fMRI and a resting-state fMRI. The fMRI experiment showed that increased disinhibited eating was positively associated with a greater insular response to palatable liquid consumption, while increased impulsivity was positively correlated with a greater amygdala response. The resting-state fMRI experiment showed that increased disinhibited eating was positively correlated with strengthened intrinsic functional connectivity between the insula and the amygdala, adjusting for sex (estimates of the beta coefficients = 0.146, standard error = 0.068, p = 0.040). Given that the amygdala and insular cortex are structurally and functionally connected and involved in trait impulsivity and ingestive behavior, our findings suggest that increased disinhibited eating would be associated with impulsivity via strengthened intrinsic functional connectivity between the insula and amygdala and linked to maladaptive eating.
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Affiliation(s)
- Yuko Nakamura
- UTokyo Center for Integrative Science of Human Behavior, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- UTokyo Center for Integrative Science of Human Behavior, The University of Tokyo, Tokyo, Japan.,International Research Center for Neurointelligence, The University of Tokyo Institutes for Advanced Study, Tokyo, Japan.,UTokyo Institute for Diversity and Adaptation of Human Mind, The University of Tokyo, Tokyo, Japan.,Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
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Paixão C, Dias CM, Jorge R, Carraça EV, Yannakoulia M, de Zwaan M, Soini S, Hill JO, Teixeira PJ, Santos I. Successful weight loss maintenance: A systematic review of weight control registries. Obes Rev 2020; 21:e13003. [PMID: 32048787 PMCID: PMC9105823 DOI: 10.1111/obr.13003] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/25/2022]
Abstract
Weight loss maintenance is a major challenge for obesity treatment. Weight control registries can be useful in identifying psychological and behavioural factors that could contribute to better long-term success. The objective of this study is to describe the existing weight control registries and their participants and identify correlates of weight loss maintenance. A comprehensive search of peer-reviewed articles published until November 2018 was conducted in PubMed, Web of Science, and Scopus. Studies that reported results from weight control registries were considered. Fifty-two articles, corresponding to five registries (the United States, Portugal, Germany, Finland, and Greece), were included. Registries differed in inclusion criteria and procedures. Of 51 identified weight loss and maintenance strategies, grouped in 14 domains of the Oxford Food and Activity Behaviors taxonomy, the following were the most frequently reported: having healthy foods available at home, regular breakfast intake, increasing vegetable consumption, decreasing sugary and fatty foods, limiting certain foods, and reducing fat in meals. Increased physical activity was the most consistent positive correlate of weight loss maintenance. To our knowledge, this is the first systematic review of information about successful weight loss maintenance obtained from weight control registries. Key common influential characteristics of success were identified, which can inform future prospective studies and weight management initiatives.
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Affiliation(s)
- Catarina Paixão
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Carlos M Dias
- Centro de Investigação em Saúde Pública (CISP), NOVA-Escola Nacional de Saúde Pública, Lisbon, Portugal.,Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Rui Jorge
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal.,Unidade de Investigação do Instituto Politécnico de Santarém, Escola Superior Agrária, Instituto Politécnico de Santarém, Santarém, Portugal
| | - Eliana V Carraça
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Sirpa Soini
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - James O Hill
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Pedro J Teixeira
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Inês Santos
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal.,Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Abstract
PURPOSE OF REVIEW Literature from the past five years exploring roles of Three-Factor Eating Questionnaire (TFEQ) Restraint and Disinhibition in relation to adult obesity and eating disturbance (ED) was reviewed. RECENT FINDINGS Restraint has a mixed impact on weight regulation, diet quality, and vulnerability to ED, where it is related detrimentally to weight regulation, diet, and psychopathology, yet can serve as a protective factor. The impact of Disinhibition is potently related to increased obesity, poorer diet, hedonically driven food choices, and a higher susceptibility to ED. Restraint and Disinhibition have distinct influences on obesity and ED and should be targeted differently in interventions. Further work is required to elucidate the mechanisms underlying TFEQ eating behavior traits.
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Affiliation(s)
- Eleanor J Bryant
- Division of Psychology, Faculty of Management, Law and Social Sciences, University of Bradford, Bradford, UK.
| | - Javairia Rehman
- Division of Psychology, Faculty of Management, Law and Social Sciences, University of Bradford, Bradford, UK
| | - Lisa B Pepper
- Division of Psychology, Faculty of Management, Law and Social Sciences, University of Bradford, Bradford, UK
| | - Elizabeth R Walters
- Division of Psychology, Faculty of Management, Law and Social Sciences, University of Bradford, Bradford, UK
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Sensation seeking, binge-type eating disorders, victimization, and PTSD in the National Women's Study. Eat Behav 2018; 30:120-124. [PMID: 30012278 DOI: 10.1016/j.eatbeh.2018.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 06/28/2018] [Accepted: 07/03/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Higher degrees of sensation seeking (SS) are reported in community and clinical samples of individuals with eating disorders with binge-type features (BTEDs), but no reports exist in representative probability samples of adult women. Additionally, SS has been linked to victimization and PTSD, also associated with BTEDs, yet interrelationships between these variables are unexplored. METHODS A national, probability sample of 3006 adult women (≥18 y/o) completed structured telephone interviews including assessments for victimization, PTSD, bulimia nervosa (BN) and binge eating disorder (BED). The survey included the 6 items of the Disinhibition-Intentions for the Future (DIF) subscale of Zuckerman's Sensation Seeking Scale-VI, which asks how likely participants would be to engage in given activities. Total SS score (TSSS-DIFS) was the sum of the 6 items' scores. Differences among the 3 groups (BN, BED, non-BN/BED) were compared using ANOVA covaried by age and post-hoc t-tests. Multiple regression tested the effects of age, number of victimization experiences (NVE), lifetime PTSD, and BTEDs on TSSS-DIFS. RESULTS There were significant differences in TSSS-DIFS across BTED diagnoses (p ≤ .001). Participants with BN (p ≤ .002) and those with BED (p ≤ .01) had significantly higher scores than those without BTEDs. These findings persisted in both groups after correcting for NVE and lifetime PTSD. TSSS-DIFS was significantly higher in participants with BTED with PTSD versus those without (p ≤ .025). DISCUSSION SS traits related to disinhibition occur more commonly in U.S. adult women with BN and BED, even after controlling for NVE and PTSD, which were also associated with higher TSSS-DIFS.
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Opwis M, Schmidt J, Martin A, Salewski C. Gender differences in eating behavior and eating pathology: The mediating role of rumination. Appetite 2017; 110:103-107. [DOI: 10.1016/j.appet.2016.12.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 11/14/2016] [Accepted: 12/14/2016] [Indexed: 10/20/2022]
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Forney KJ, Bodell LP, Haedt-Matt AA, Keel PK. Incremental validity of the episode size criterion in binge-eating definitions: An examination in women with purging syndromes. Int J Eat Disord 2016; 49:651-62. [PMID: 26841103 PMCID: PMC4942344 DOI: 10.1002/eat.22508] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/21/2015] [Accepted: 12/28/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Of the two primary features of binge eating, loss of control (LOC) eating is well validated while the role of eating episode size is less clear. Given the ICD-11 proposal to eliminate episode size from the binge-eating definition, the present study examined the incremental validity of the size criterion, controlling for LOC. METHOD Interview and questionnaire data come from four studies of 243 women with bulimia nervosa (n = 141) or purging disorder (n = 102). Hierarchical linear regression tested if the largest reported episode size, coded in kilocalories, explained additional variance in eating disorder features, psychopathology, personality traits, and impairment, holding constant LOC eating frequency, age, and body mass index (BMI). Analyses also tested if episode size moderated the association between LOC eating and these variables. RESULTS Holding LOC constant, episode size explained significant variance in disinhibition, trait anxiety, and eating disorder-related impairment. Episode size moderated the association of LOC eating with purging frequency and depressive symptoms, such that in the presence of larger eating episodes, LOC eating was more closely associated with these features. Neither episode size nor its interaction with LOC explained additional variance in BMI, hunger, restraint, shape concerns, state anxiety, negative urgency, or global functioning. DISCUSSION Taken together, results support the incremental validity of the size criterion, in addition to and in combination with LOC eating, for defining binge-eating episodes in purging syndromes. Future research should examine the predictive validity of episode size in both purging and nonpurging eating disorders (e.g., binge eating disorder) to inform nosological schemes. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:651-662).
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Affiliation(s)
- K. Jean Forney
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Lindsay P. Bodell
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida,Correspondence to: Pamela K. Keel, Ph.D., Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL, 32306.
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Yilmaz Z, Davis C, Loxton NJ, Kaplan AS, Levitan RD, Carter JC, Kennedy JL. Association between MC4R rs17782313 polymorphism and overeating behaviors. Int J Obes (Lond) 2015; 39:114-20. [PMID: 24827639 PMCID: PMC4232480 DOI: 10.1038/ijo.2014.79] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Revised: 04/10/2014] [Accepted: 04/14/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES Melanocortins have a crucial role in appetite and weight regulation. Although the melanocortin 4 receptor (MC4R) gene has been repeatedly linked to obesity and antipsychotic-induced weight gain, the mechanism behind how it leads to this effect in still undetermined. The goal of this study was to conduct an in-depth and sophisticated analysis of MC4R polymorphisms, body mass index (BMI), eating behavior and depressed mood. SUBJECTS/METHODS We genotyped 328 individuals of European ancestry on the following MC4R markers based on the relevant literature on obesity and antipsychotic-induced weight gain: rs571312, rs17782313, rs489693, rs11872992, and rs8087522. Height and weight were measured, and information on depressed mood and overeating behaviors was obtained during the in-person assessment. RESULTS BMI was associated with rs17782313 C allele; however, this finding did not survive correction for multiple testing (P = 0.018). Although rs17782313 was significantly associated with depressed mood and overeating behaviors, tests of indirect effects indicated that emotional eating and food cravings, rather than depressed mood, uniquely accounted for the effect of this marker and BMI (n = 152). CONCLUSIONS To our knowledge, this is the first study to investigate the link between MC4R rs17782313, mood and overeating behavior, as well as to demonstrate possible mechanisms behind MC4R's influence on body weight. If replicated in a larger sample, these results may have important clinical implications, including potential for the use of MC4R agonists in the treatment of obesity and disordered eating.
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Affiliation(s)
- Zeynep Yilmaz
- Center of Excellence for Eating Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Clinical Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Caroline Davis
- Clinical Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Kinesiology & Health Sciences, York University, Toronto, Ontario, Canada
- Eating Disorders Program, Toronto General Hospital, Toronto, Ontario, Canada
| | - Natalie J. Loxton
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Allan S. Kaplan
- Clinical Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Robert D. Levitan
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Mood and Anxiety Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - James L. Kennedy
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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