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Petersen JM, Barney JL, Barrett TS, Lensegrav-Benson T, Quakenbush-Roberts B, Twohig MP. Values engagement as a predictor of eating disorder severity in a residential sample of female adolescents with eating disorders. Eat Disord 2022; 31:388-404. [PMID: 36469583 DOI: 10.1080/10640266.2022.2141710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Values are freely chosen life directions and/or qualities of being that can motivate behavior change. There is nascent support for the utility of values work as a part of the therapeutic process across treatments, particularly in third wave therapy approaches (e.g., acceptance and commitment therapy). However, therapeutic values work is underresearched in clinical samples of youth. The aim of the present study is to examine the role of the two distinct values processes (engagement and obstruction), body image inflexibility, alongside other common comorbid symptoms of eating disorders (anxiety, depression) in a sample of female adolescents with eating disorders attending a residential eating disorder treatment program. Participants (N = 75) were patients at a residential eating disorder treatment facility and completed a battery of measures at time of admission. Correlational analyses and multiple regression were performed. Results found correlations between eating disorder severity, values engagement, values obstruction, body image flexibility, anxiety, and depression in the expected directions. Regression results found body image inflexibility, progression towards values, and anxiety as significant predictors of eating disorder severity (adjusted R2 = .54). This study points to the importance of emphasizing values engagement in youth with eating disorders, highlighting a potential treatment target for future research.
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Affiliation(s)
- Julie M Petersen
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - Jen L Barney
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - Tyson S Barrett
- Department of Psychology, Utah State University, Logan, Utah, USA
| | | | | | - Michael P Twohig
- Department of Psychology, Utah State University, Logan, Utah, USA
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Barney JL, Barrett TS, Lensegrav-Benson T, Quakenbush B, Twohig MP. Examining a mediation model of body image-related cognitive fusion, intuitive eating, and eating disorder symptom severity in a clinical sample. Eat Weight Disord 2022; 27:2181-2192. [PMID: 35122638 DOI: 10.1007/s40519-021-01352-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/21/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study sought to explore the associations between Intuitive Eating (IE), eating disorder (ED) symptom severity, and body image-related cognitive fusion within a clinical sample. IE was also examined as a possible mediator in the relationship between body image-related fusion and ED symptoms. METHODS This study includes cross-sectional analyses with data from 100 adult females and 75 adolescent females seeking residential treatment for an ED. Self-reported demographic information, ED symptoms, IE behaviors, and body image-related cognitive fusion were collected from participants within the first week of treatment following admission to the same residential ED treatment facility. RESULTS ED symptom severity was significantly negatively associated with three of the four domains of IE; unconditional permission to eat, reliance on hunger and satiety cues, and body-food choice congruence. A significant mediational effect of IE on the relationship between body image-related fusion and ED symptoms through IE behaviors was observed (β = 11.3, SE = 0.003, p < 0.001). This effect was only observed for the unconditional permission to eat (β = 0.13, p = 0.003) and reliance on hunger and satiety cues (β = 0.10, p = 0.005) domains of IE when the domains were subsequently analyzed individually. CONCLUSION Unconditional permission to eat and reliance on hunger and satiety cues appear to be particularly influential domains of IE in the relationship between body image-related fusion and ED symptom severity. It is possible that changes in these IE domains may be mechanisms through which body image-related fusion influences ED symptoms. Future longitudinal research is needed to better understand the relationship between body image-related cognitive fusion and IE and the potential for targeting these constructs specifically in the context of ED treatment. LEVEL OF EVIDENCE Level V, cross-sectional analysis from descriptive study.
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Affiliation(s)
- Jennifer L Barney
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT, 84322, USA.
| | - Tyson S Barrett
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT, 84322, USA
| | | | - Benita Quakenbush
- Avalon Hills Eating Disorder Specialists, 175 E 100 N, Logan, UT, 84321, USA
| | - Michael P Twohig
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT, 84322, USA
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Gibson D, Benabe J, Watters A, Oakes J, Mehler PS. Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients-a pilot study. J Eat Disord 2021; 9:146. [PMID: 34736530 PMCID: PMC8567337 DOI: 10.1186/s40337-021-00502-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stimulant laxative abuse as a purging behavior can be profound in those with eating disorders. However, the psychopathology leading to stimulant laxative abuse is poorly understood. Furthermore, the medical impact of stimulant laxative abuse has not been studied in this population. METHODS Six individuals abusing stimulant laxatives underwent a barium enema to assess for evidence of the cathartic colon syndrome and 29 individuals engaging in any purging behaviors completed the Tri-dimensional Personality Questionnaire-Short Form, Sensitivity to Punishment/Sensitivity to Reward Questionnaire-Short Form, Beck Depression Inventory, and the State Trait Anxiety Inventory questionnaires. RESULTS Three of the six patients completing the barium enema had the radiographic findings consistent with cathartic colon. Individuals engaging in laxative abuse showed higher Novelty Seeking compared to those engaging in other forms of purging, and those engaging in any form of purging behavior showed greater Sensitivity to Punishment compared to Sensitivity to Reward. There was also the presence of greater Harm Avoidance than Reward Dependence in this population. CONCLUSION There may be different psychopathology that contributes to the abuse of stimulant laxatives than that associated with other forms of purging. Regardless of the driving factor, further research is warranted to discover best therapeutic interventions given the potential to develop the cathartic colon syndrome with ongoing use of stimulant laxatives. Cathartic colon is a condition whereby the colon, or lower intestine, is converted into an inert tube incapable of propagating fecal matter. It is thought to develop due to over-use of stimulant laxatives. However, it is unclear if this condition truly exists and whether it contributes to the constipation experienced by individuals with eating disorders who have extensive past histories of abusing laxatives. It is also unclear if laxative abuse presents with different medical complications than other forms of purging. The purpose of this study is to determine whether radiographic evidence of cathartic colon can be found in eating disorder patients abusing stimulant laxatives, whether there are different medical complications with laxative abuse versus other forms of purging, and to examine the psychological composition of individuals who engage in severe laxative abuse. Specifically, the authors investigated the interrelationship between Harm Avoidance and Reward Dependence, with emphasis on gaining a better understanding of Reward Dependence by examining both Sensitivity to Reward and Sensitivity to Punishment in patients who engage in severe laxative abuse. Our findings suggest that stimulant laxative abuse may cause the development of cathartic colon changes and that there may be unique psychopathology that contributes to the abuse of stimulant laxatives. Given the higher Novelty Seeking personality-dimension in those abusing laxatives, it is possible that this purging behavior may be considered addiction-like in nature, which would have distinct treatment implications.
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Affiliation(s)
- Dennis Gibson
- ACUTE Center for Eating Disorders at Denver Health, 723 Delaware Street, Denver, CO, 80204, USA.
- Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA.
| | - Jodie Benabe
- Department of Psychiatry, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Ashlie Watters
- ACUTE Center for Eating Disorders at Denver Health, 723 Delaware Street, Denver, CO, 80204, USA
- Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Judy Oakes
- ACUTE Center for Eating Disorders at Denver Health, 723 Delaware Street, Denver, CO, 80204, USA
- Department of Medicine, Denver Health Hospital Authority, 780 Bannock Street, Denver, CO, 80204, USA
| | - Philip S Mehler
- ACUTE Center for Eating Disorders at Denver Health, 723 Delaware Street, Denver, CO, 80204, USA
- Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
- Eating Recovery Center, 7351 E Lowry Blvd, Denver, CO, 80230, USA
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Sommer LM, Halbeisen G, Erim Y, Paslakis G. Two of a Kind? Mapping the Psychopathological Space between Obesity with and without Binge Eating Disorder. Nutrients 2021; 13:3813. [PMID: 34836069 PMCID: PMC8625654 DOI: 10.3390/nu13113813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Obesity (OB) is a frequent co-morbidity in Binge Eating Disorder (BED), suggesting that both conditions share phenotypical features along a spectrum of eating-related behaviors. However, the evidence is inconsistent. This study aimed to comprehensively compare OB-BED patients against OB individuals without BED and healthy, normal-weight controls in general psychopathological features, eating-related phenotypes, and early life experiences. (2) Methods: OB-BED patients (n = 37), OB individuals (n = 50), and controls (n = 44) completed a battery of standardized questionnaires. Responses were analyzed using univariate comparisons and dimensionality reduction techniques (linear discriminant analysis, LDA). (3) Results: OB-BED patients showed the highest scores across assessments (e.g., depression, emotional and stress eating, food cravings, food addiction). OB-BED patients did not differ from OB individuals in terms of childhood traumatization or attachment styles. The LDA revealed a two-dimensional solution that distinguished controls from OB and OB-BED in terms of increasing problematic eating behaviors and attitudes, depression, and childhood adversities, as well as OB-BED from OB groups in terms of emotional eating tendencies and self-regulation impairments. (4) Conclusions: Findings support the idea of a shared spectrum of eating-related disorders but also highlight important distinctions relevant to identifying and treating BED in obese patients.
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Affiliation(s)
- Laura Marie Sommer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.M.S.); (Y.E.)
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westfalia, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany;
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.M.S.); (Y.E.)
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westfalia, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany;
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Majd M, Smyth JM, Lv N, Xiao L, Snowden MB, Venditti EM, Williams LM, Ajilore OA, Suppes T, Ma J. The factor structure of depressive symptoms in patients with obesity enrolled in the RAINBOW clinical trial. J Affect Disord 2021; 281:367-375. [PMID: 33348180 PMCID: PMC7855596 DOI: 10.1016/j.jad.2020.11.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 09/06/2020] [Accepted: 11/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Examining variability in the presenting symptoms of depression may be particularly important in characterizing depression in patients with comorbid conditions such as obesity. Identifying the underlying constructs of depression in such patients may produce phenotypic information to aid diagnosis and treatment decisions. OBJECTIVE To examine the latent factors of symptoms using the depression Symptom Checklist (SCL-20) and the Patient Health Questionnaire (PHQ-9), separately, in patients with obesity and elevated depressive symptoms. METHODS Exploratory factor analysis (EFA) was performed on baseline data from 409 patients with obesity and elevated depressive symptoms recruited in primary care. Bootstrap analysis was performed to estimate the precision and potential replicability of identified latent factors. RESULTS Participants (70% women, mean age of 51.0 ± 12.1 years) had moderate depression. EFA of the SCL-20 suggested two reliable factors: dysphoric mood (71% of the variance) and anhedonia (15% of the variance). EFA of the PHQ-9 yielded one factor: dysphoric mood (87% of the variance). Bootstrapped results supported the replicability of these results. The top most endorsed symptoms were feeling low energy, overeating and disturbed sleep. LIMITATIONS The generalizability of these findings to severe depression may be limited. CONCLUSIONS Patients with elevated depressive symptoms and obesity present with heterogeneous symptoms. The SCL-20 seems more sensitive than the PHQ-9 for differentiating symptom profiles in this population. Some possible reasons include: 1) differences in number of scale items, and 2) differences in the aspects of depression they tap into; the SCL-20 measures the severity of symptoms, whereas the PHQ-9 measures the frequency of symptoms.
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Affiliation(s)
- Marzieh Majd
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Joshua M Smyth
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA; Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA; Penn State Milton S. Hershey Medical Center, The Pennsylvania State University, PA, USA
| | - Nan Lv
- Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Lan Xiao
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
| | - Mark B Snowden
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Elizabeth M Venditti
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Olusola A Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Trisha Suppes
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Jun Ma
- Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA; Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
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Glisenti K, Strodl E, King R, Greenberg L. The feasibility of emotion-focused therapy for binge-eating disorder: a pilot randomised wait-list control trial. J Eat Disord 2021; 9:2. [PMID: 33407948 PMCID: PMC7789500 DOI: 10.1186/s40337-020-00358-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 12/06/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Research into psychotherapy for binge-eating disorder (BED) has focused mainly on cognitive behavioural therapies, but efficacy, failure to abstain, and dropout rates continue to be problematic. The experience of negative emotions is among the most accurate predictors for the occurrence of binge eating episodes in BED, suggesting benefits to exploring psychological treatments with a more specific focus on the role of emotion. The present study aimed to explore the feasibility of individual emotion-focused therapy (EFT) as a treatment for BED by examining the outcomes of a pilot randomised wait-list controlled trial. METHODS Twenty-one participants were assessed using a variety of feasibility measures relating to recruitment, credibility and expectancy, therapy retention, objective binge episodes and days, and binge eating psychopathology outcomes. The treatment consisted of 12 weekly one-hour sessions of EFT for maladaptive emotions over 3 months. A mixed model approach was utilised with one between effect (group) using a one-way analysis of variance (ANOVA) to test the hypothesis that participants immediately receiving the EFT treatment would demonstrate a greater degree of improvement on outcomes relating to objective binge episodes and days, and binge eating psychopathology, compared to participants on the EFT wait-list; and one within effect (time) using a repeated-measures ANOVA to test the hypothesis that participation in the EFT intervention would result in significant improvements in outcome measures from pre to post-therapy and then maintained at follow-up. RESULTS Recruitment, credibility and expectancy, therapy retention outcomes indicated EFT is a feasible treatment for BED. Further, participants receiving EFT demonstrated a greater degree of improvement in objective binge episodes and days, and binge eating psychopathology compared to EFT wait-list control group participants. When participants in the EFT wait-list control group then received treatment and outcomes data were combined with participants who initially received the treatment, EFT demonstrated significant improvement in objective binge episodes and days, and binge eating psychopathology for the entire sample. CONCLUSIONS These findings provide further preliminary evidence for the feasibility of individual EFT for BED and support more extensive randomised control trials to assess efficacy. TRIAL REGISTRATION The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12620000563965 ) on 14 May 2020.
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Affiliation(s)
- Kevin Glisenti
- School of Psychology and Counselling, Queensland University of Technology, Faculty of Health, Brisbane, Queensland, Australia.
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Faculty of Health, Brisbane, Queensland, Australia
| | - Robert King
- School of Psychology and Counselling, Queensland University of Technology, Faculty of Health, Brisbane, Queensland, Australia
| | - Leslie Greenberg
- Department of Psychology, York University, Faculty of Health, Toronto, Canada
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Carr MM, Grilo CM. Examining heterogeneity of binge-eating disorder using latent class analysis. J Psychiatr Res 2020; 130:194-200. [PMID: 32828025 PMCID: PMC7554082 DOI: 10.1016/j.jpsychires.2020.07.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 11/15/2022]
Abstract
There is significant variability in the type and severity of symptoms reported by individuals diagnosed with binge-eating disorder (BED). Using latent class analysis (LCA), the current study aimed to investigate potential sources of heterogeneity among individuals with BED. Participants were 775 treatment-seeking adults with DSM-IV-defined BED. Doctoral research clinicians reliably assessed participants for BED and associated eating-disorder psychopathology using the Structured Clinical Interview for DSM-IV Disorders and the Eating Disorder Examination (EDE) interview, measured weight and height, and participants completed a battery of self-report measures. Based on fit statistics and class interpretability, a 2-class model yielded the best overall fit to the data. The two classes were most distinct with respect to differences in body image concerns, distress about binge-eating, and depressive symptomology. Number of binge episodes were significantly different between classes, though the effect was much smaller. Body mass index was not a significant covariate in the majority of models. The results show that many of the features currently used to define BED (e.g., binge-eating frequency) are not helpful in explaining heterogeneity among individuals with BED. Instead, body image disturbances, which are not currently included as a part of the diagnostic classification system, appear to differentiate distinct subgroups of individuals with BED. Future research examining subgroups based on body image could be integral to resolving ongoing conflicting evidence related to the etiology and maintenance of BED.
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Affiliation(s)
- Meagan M. Carr
- Department of Psychiatry, Yale School of Medicine, 300
George Street New Haven CT 06511
| | - Carlos M. Grilo
- Department of Psychiatry, Yale School of Medicine, 300
George Street New Haven CT 06511,Department of Psychology, Yale University, Box 208205 New
Haven CT 06520
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Gruszka W, Wyskida K, Owczarek AJ, Jędrusik E, Alraquayee N, Glinianowicz M, Bąk-Sosnowska M, Chudek J, Olszanecka-Glinianowicz M. The occurrence of depressive symptoms in obese subjects starting treatment and not seeking treatment for obesity. Eat Weight Disord 2020; 25:283-289. [PMID: 30264389 PMCID: PMC7083818 DOI: 10.1007/s40519-018-0578-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 09/11/2018] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION The psychological profile of obese people deciding to start obesity treatment may be different from those not choosing to seek the therapy. Previous studies have shown a higher incidence of depression in obese than in normal weight people. However, data are lacking concerning the occurrence of depressive symptoms and their severity in obese subjects who do or do not decide to start treatment for obesity. Therefore, the aim of this study was to evaluate the prevalence and severity of depressive symptoms among obese people starting treatment and not seeking treatment for obesity. MATERIALS AND METHODS Enrolled subjects were 331 adults (241 women, 90 men), including 193 obese subjects starting treatment for obesity (46.8 ± 13.2 years, BMI 37.6 ± 5.5 kg/m2) and 138 obese volunteers never seeking treatment for obesity (44.3 ± 12.5 years, BMI 34.7 ± 4.3 kg/m2). Depression levels were determined using the Beck Depression Inventory (BDI). RESULTS The level of depression was significantly higher among those starting treatment for obesity than those never seeking treatment for obesity (13.2 ± 9.2 vs. 9.5 ± 7.9 points; p < 0.001). This difference was statistically significant in women (14.4 ± 9.2 and 11.0 ± 8.2 points, respectively; p < 0.01), but not in men (7.2 ± 6.4 and 7.3 ± 7.1 points, respectively; p = 0.95). There were more women with moderate/severe depressive symptoms in the group starting treatment than in the group not seeking treatment for obesity (44.7 and 24.4%, respectively). No such difference was observed in men. CONCLUSIONS Obese subjects, especially women, with depressive symptoms are more likely to start treatment for obesity. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Wojciech Gruszka
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland.
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków Street 18 20, 40-752, Katowice, Poland.
| | - Katarzyna Wyskida
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
| | - Aleksander J Owczarek
- Department of Statistics, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Ewa Jędrusik
- Department of Statistics, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Nasser Alraquayee
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków Street 18 20, 40-752, Katowice, Poland
| | - Mateusz Glinianowicz
- Department of Psychology, Chair of Social Sciences and Humanities, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Monika Bąk-Sosnowska
- Department of Psychology, Chair of Social Sciences and Humanities, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Jerzy Chudek
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Medyków Street 18 20, 40-752, Katowice, Poland
- Department of Internal Medicine and Oncological Chemotherapy, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
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Vaughan EM, Johnston CA, Moreno JP, Cheskin LJ, Dutton GR, Gee M, Gaussoin SA, Knowler WC, Rejeski WJ, Wadden TA, Yanovski SZ, Foreyt JP. Symptom prevalence differences of depression as measured by BDI and PHQ scales in the Look AHEAD study. Obes Sci Pract 2020; 6:28-38. [PMID: 32128240 PMCID: PMC7042097 DOI: 10.1002/osp4.378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To compare depressive symptomatology as assessed by two frequently used measures, the Beck Depression Inventory (BDI-1A) and Patient Health Questionnaire (PHQ-9). METHODS Investigators conducted a cross-sectional secondary analysis of data collected as part of the follow-up observational phase of the Look AHEAD study. Rates of agreement between the BDI-1A and PHQ-9 were calculated, and multivariable logistic regression was used to examine the relationship between differing depression category classifications and demographic factors (ie, age, sex, race/ethnicity) or comorbidities (ie, diabetes control, cardiovascular disease). RESULTS A high level of agreement (κ = 0.47, 95% CI (0.43 to 0.50)) was found in the level of depressive symptomatology between the BDI-1A and PHQ-9. Differing classifications (minimal, mild, moderate, and severe) occurred in 16.8% of the sample. Higher scores on the somatic subscale of the BDI-1A were significantly associated with disagreement as were having a history of cardiovascular disease, lower health-related quality of life, and minority racial/ethnic classification. CONCLUSIONS Either the BDI-1A or PHQ-9 can be used to assess depressive symptomatology in adults with overweight/obesity and type 2 diabetes. However, further assessment should be considered in those with related somatic symptoms, decreased quality of life, and in racial/ethnic minority populations.
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Affiliation(s)
| | - Craig A. Johnston
- Department of Health and Human PerformanceUniversity of HoustonHoustonTexas
| | - Jennette P. Moreno
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics‐NutritionBaylor College of MedicineHoustonTexas
| | - Lawrence J. Cheskin
- Department of Nutrition and Food Studies, College of Health and Human ServicesGeorge Mason UniversityFairfaxVirginia
- Department of Health, Behavior & SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreMaryland
| | - Gareth R. Dutton
- Division of Preventive MedicineUniversity of Alabama at BirminghamBirminghamAlabama
| | - Molly Gee
- Department of MedicineBaylor College of MedicineHoustonTexas
| | - Sarah A. Gaussoin
- Department of Biostatistical Sciences and Data Science, Division of Public Health ServicesWake Forest School of MedicineWinston‐SalemNorth Carolina
| | - William C. Knowler
- Diabetes Epidemiology and Clinical Research SectionNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of HealthPhoenixArizona
| | - W. Jack Rejeski
- Division of Public Health SciencesWake Forest School of MedicineWinston‐SalemNorth Carolina
| | - Thomas A. Wadden
- Department of PsychiatryPerelman School of Medicine, University of PennsylvaniaPhiladelphiaPennsylvania
| | - Susan Z. Yanovski
- Division of Digestive Diseases and NutritionNational Institute of Diabetes and Digestive and Kidney DiseasesBethesdaMaryland
| | - John P. Foreyt
- Department of MedicineBaylor College of MedicineHoustonTexas
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Inflammation and the dimensions of depression: A review. Front Neuroendocrinol 2020; 56:100800. [PMID: 31654681 DOI: 10.1016/j.yfrne.2019.100800] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 09/22/2019] [Accepted: 10/20/2019] [Indexed: 12/15/2022]
Abstract
Patients with depressive disorders show a wide range of clinical manifestations including cognitive and neurovegetative symptoms. Importantly, these symptoms can differ in terms of biological etiology, and deconstructing depression into specific symptoms may provide valuable insight into the underlying neurobiology. Little research has examined inflammation in the context of depressive dimensions. Here we conduct a narrative review of the existing literature (21 studies) to elucidate whether the depression-inflammation link is symptom specific. Overall, there is evidence that an association exists between neurovegetative symptoms of depression and inflammation, independent of cognitive symptoms. The same cannot be said of cognitive symptoms and inflammation. There is also some evidence of gender differences in the directionality of the relationship between depression and inflammation. Potential explanations for these findings, limitations of the existing literature and recommendations for future research design are discussed.
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Glisenti K, Strodl E, King R. Emotion-focused therapy for binge-eating disorder: A review of six cases. Clin Psychol Psychother 2018; 25:842-855. [PMID: 30118179 DOI: 10.1002/cpp.2319] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 06/06/2018] [Accepted: 07/14/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to provide preliminary evidence of the usefulness of emotion-focused therapy (EFT) for binge-eating disorder (BED). METHODS We used a single-subject design in which 12 weeks of individual EFT were applied nonconcurrently to six female adult participants with BED, following three weekly baseline sessions. Participants were assessed for binge-eating psychopathology and emotion regulation difficulties on a weekly basis during baseline and treatment. They were assessed on a 2-, 4-, and 8-week basis during posttreatment, and they were assessed for binge-eating episodes, eating disorder attitudes, alexithymia, and psychiatric comorbidity at pretreatment and posttreatment. RESULTS All cases experienced reliable recovery from binge-eating psychopathology and a significant decrease in binge-eating frequency. For all cases, there was reliable improvement or recovery on eating and shape concerns, and there was improvement on weight concern for the majority of cases. For all cases, reliable recovery or improvement occurred in overall emotion regulation. Most cases that were in the clinical range pretreatment recovered for anxiety, and reliable improvement in or recovery from depression occurred for all cases. There was reliable recovery or improvement in alexithymia for half of the cases; however, the other half experienced no change or deteriorated. There were no treatment dropouts. CONCLUSION Individual EFT demonstrates potential as a psychological treatment for BED. The current study provides preliminary evidence to guide the development of a more extensive trial to test the efficacy of individual EFT for BED as well as to identify possible mechanisms of change.
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Affiliation(s)
- Kevin Glisenti
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Robert King
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
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12
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Lee EB, Ong CW, Twohig MP, Lensegrav-Benson T, Quakenbush-Roberts B. Increasing body image flexibility in a residential eating disorder facility: Correlates with symptom improvement. Eat Disord 2018; 26:185-199. [PMID: 28929944 DOI: 10.1080/10640266.2017.1366229] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the effects of changes in body image psychological flexibility over the course of treatment on various outcome variables. METHOD Participants included 103 female, residential patients diagnosed with an eating disorder. Pretreatment and posttreatment data were collected that examined body image psychological flexibility, general psychological flexibility, symptom severity, and other outcome variables. RESULTS Changes in body image psychological flexibility significantly predicted changes in all outcome measures except for obsessive-compulsive symptoms after controlling for body mass index, depression, and anxiety. Additionally, these results were maintained after controlling for general psychological flexibility, contributing to the incremental validity of the BI-AAQ. DISCUSSION This study suggests that changes in body image psychological flexibility meaningfully predict changes in various treatment outcomes of interest, including eating disorder risk, quality of life, and general mental health. Findings indicate that body image psychological flexibility might be a viable target for eating disorder treatment.
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Affiliation(s)
- Eric B Lee
- a Psychology Department , Utah State University , Logan , Utah , USA
| | - Clarissa W Ong
- a Psychology Department , Utah State University , Logan , Utah , USA
| | - Michael P Twohig
- a Psychology Department , Utah State University , Logan , Utah , USA
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13
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Jayawickreme N, Verkuilen J, Jayawickreme E, Acosta K, Foa EB. Measuring Depression in a Non-Western War-Affected Displaced Population: Measurement Equivalence of the Beck Depression Inventory. Front Psychol 2017; 8:1670. [PMID: 29018389 PMCID: PMC5622946 DOI: 10.3389/fpsyg.2017.01670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 09/11/2017] [Indexed: 11/25/2022] Open
Abstract
Depression is commonly seen in survivors of conflict and disaster across the world. There is a dearth of research on the validity of commonly used measures of depression in these populations. Measurements of depression that are used in multiple contexts need to meet measurement equivalence, i.e., the instrument measures the same construct in the same manner across different groups. The Beck Depression Inventory (BDI) was administered to female trauma survivors in the United States (n = 268) and female survivors of war in Sri Lanka (n = 149). Three metrics of measurement equivalence—structural, metric, and scalar—were examined. Two- and three-factor structures of the BDI that have been identified in other populations did not provide a good fit for our data. However, a bifactor model revealed a similar general distress dimension across populations, but dissimilar secondary dimensions or subfactors. The Sri Lankan subfactor comprised of predominantly somatic symptoms and the United States subfactor comprised of cognitive and somatic symptoms. While intercepts of individual BDI items differed, their differences seem to be offsetting. Total BDI scores across these two populations are roughly comparable, although caution is recommended when interpreting them. Making comparisons on subscales is not recommended.
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Affiliation(s)
- Nuwan Jayawickreme
- Department of Psychology, Manhattan College, New York City, NY, United States
| | - Jay Verkuilen
- Department of Educational Psychology, City University of New York, New York City, NY, United States
| | - Eranda Jayawickreme
- Department of Psychology, Wake Forest University, Winston-Salem, NC, United States
| | - Kaylaliz Acosta
- Department of Psychology, Manhattan College, New York City, NY, United States
| | - Edna B Foa
- Department of Psychiatry, Center for the Treatment and Study of Anxiety, University of Pennsylvania, Philadelphia, PA, United States
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14
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Lee EB, Smith BM, Twohig MP, Lensegrav-Benson T, Quakenbush-Roberts B. Assessment of the body Image-Acceptance and Action Questionnaire in a female residential eating disorder treatment facility. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017. [DOI: 10.1016/j.jcbs.2016.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Zientek F, Winter K, Müller A, Rullmann M, Luthardt J, Becker GA, Bresch A, Patt M, Sabri O, Hilbert A, Hesse S. Effortful control as a dimension of temperament is negatively associated with prefrontal serotonin transporter availability in obese and non-obese individuals. Eur J Neurosci 2016; 44:2460-2466. [PMID: 27519298 DOI: 10.1111/ejn.13362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/26/2016] [Accepted: 08/02/2016] [Indexed: 11/25/2022]
Abstract
There is evidence that temperamental factors are associated with obesity; however, the biological mechanism of such association remains elusive. We aimed to investigate a possible association between serotonin transmission and regulative temperament in obese and non-obese individuals by using positron emission tomography (PET) imaging of serotonin transporters (SERT) and the Adult Temperament Questionnaire. Twenty-nine obese individuals with body mass index (BMI) ≥ 35 kg/m2 and 13 non-obese controls (BMI < 30 kg/m2 ) underwent PET with [11 C]-labeled DASB (highly selective for SERT) and self-completed the Effortful Control (EC) scale of the Adult Temperament Questionnaire-Short Form (ATQ). With the help of this questionnaire, we aimed to assess the capacity of self-regulation. Overall, for obese and non-obese individuals together, VOI-based (volume of interest) analysis showed significant negative correlations between SERT BPND and ATQ-EC AC (Activation Control) subscale in several brain regions (all r ≤ -0.47). Obese and non-obese individuals separated showed equally strong positive, but non-significant correlations. The analysis did not reveal any significant correlations of SERT availability and ATQ-EC IC (Inhibitory Control) or ATQ-EC AtC (Attentional Control) subscale within and between the two groups. The results indicate that regulative temperament - particularly the capacity to mitigate negatively toned impulses and to resist inappropriate avoidance behavior - might be associated with the prefrontal serotonergic system.
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Affiliation(s)
- Franziska Zientek
- Integrated Treatment and Research Centre (IFB) Adiposity Diseases, Leipzig University Medical Centre, Leipzig, Germany. .,Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany.
| | - Karsten Winter
- Translational Centre for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Michael Rullmann
- Integrated Treatment and Research Centre (IFB) Adiposity Diseases, Leipzig University Medical Centre, Leipzig, Germany
| | - Julia Luthardt
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Georg-Alexander Becker
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Anke Bresch
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Osama Sabri
- Integrated Treatment and Research Centre (IFB) Adiposity Diseases, Leipzig University Medical Centre, Leipzig, Germany.,Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Anja Hilbert
- Integrated Treatment and Research Centre (IFB) Adiposity Diseases, Leipzig University Medical Centre, Leipzig, Germany.,Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany
| | - Swen Hesse
- Integrated Treatment and Research Centre (IFB) Adiposity Diseases, Leipzig University Medical Centre, Leipzig, Germany.,Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
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16
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Lo Coco G, Sutton R, Tasca GA, Salerno L, Oieni V, Compare A. Does the Interpersonal Model Generalize to Obesity Without Binge Eating? EUROPEAN EATING DISORDERS REVIEW 2016; 24:391-8. [DOI: 10.1002/erv.2459] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/18/2016] [Accepted: 05/19/2016] [Indexed: 11/11/2022]
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17
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Chao A, White MA, Grilo CM. Smoking status and psychosocial factors in binge eating disorder and bulimia nervosa. Eat Behav 2016; 21:54-8. [PMID: 26741260 PMCID: PMC4851572 DOI: 10.1016/j.eatbeh.2015.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 11/30/2015] [Accepted: 12/16/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine eating-disorder psychopathology and depressive symptoms by smoking status (never, former, or current smoker) in persons with binge eating disorder (BED) and bulimia nervosa (BN). METHODS Participants were 575 adult volunteers from the community (mean age=36.0±12years and BMI=32.9±9.5kg/m(2); 80% white; 88% female) who were classified with BED (n=410) or BN (n=165). Participants completed a battery of questionnaires, including items about current and historical cigarette smoking, the Eating Disorder Examination -Questionnaire, and the Beck Depression Inventory. RESULTS Among those with BED, depressive symptoms were significantly higher in current smokers than former or never smokers (p=.001). There were no significant differences in depressive symptoms by smoking status in participants with BN and no differences in eating-disorder psychopathology by smoking status in either the BED or BN groups. DISCUSSION In this non-clinical group of community volunteers, we found that smoking history or status was not associated with eating disorder psychopathology in participants classified with BED and BN but was significantly associated with depressive symptoms in participants with BED.
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Affiliation(s)
- Ariana Chao
- Yale University School of Nursing, Orange, CT,University of Pennsylvania School of Nursing, Philadelphia, PA,Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Marney A. White
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Yale University School of Public Health, New Haven, CT
| | - Carlos M. Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Department of Psychology, Yale University, New Haven, CT,CASAColumbia, Yale University School of Medicine, New Haven, CT
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18
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Hesse S, Rullmann M, Luthardt J, Winter K, Hankir MK, Becker GA, Zientek F, Reissig G, Regenthal R, Drabe M, Schinke C, Bresch A, Arelin K, Lobsien D, Patt M, Meyer PM, Fasshauer M, Fenske WK, Blüher M, Stumvoll M, Sabri O. Central serotonin transporter availability in highly obese individuals compared with non-obese controls: A [(11)C] DASB positron emission tomography study. Eur J Nucl Med Mol Imaging 2015; 43:1096-104. [PMID: 26577939 DOI: 10.1007/s00259-015-3243-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 10/27/2015] [Indexed: 01/11/2023]
Abstract
PURPOSE The role of the central serotonin (5-hydroxytryptamine, 5-HT) system in feeding has been extensively studied in animals with the 5-HT family of transporters (5-HTT) being identified as key molecules in the regulation of satiety and body weight. Aberrant 5-HT transmission has been implicated in the pathogenesis of human obesity by in vivo positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging techniques. However, results obtained thus far from studies of central 5-HTT availability have been inconsistent, which is thought to be brought about mainly by the low number of individuals with a high body mass index (BMI) previously used. The aim of this study was therefore to assess 5-HTT availability in the brains of highly obese otherwise healthy individuals compared with non-obese healthy controls. METHODS We performed PET using the 5-HTT selective radiotracer [(11)C] DASB on 30 highly obese (BMI range between 35 and 55 kg/m(2)) and 15 age- and sex-matched non-obese volunteers (BMI range between 19 and 27 kg/m(2)) in a cross-sectional study design. The 5-HTT binding potential (BPND) was used as the outcome parameter. RESULTS On a group level, there was no significant difference in 5-HTT BPND in various cortical and subcortical regions in individuals with the highest BMI compared with non-obese controls, while statistical models showed minor effects of age, sex, and the degree of depression on 5-HTT BPND. CONCLUSION The overall finding of a lack of significantly altered 5-HTT availability together with its high variance in obese individuals justifies the investigation of individual behavioral responses to external and internal cues which may further define distinct phenotypes and subgroups in human obesity.
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Affiliation(s)
- Swen Hesse
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany.
- Integrated Research and Treatment Centre Adiposity Diseases Leipzig, Leipzig, Germany.
| | - Michael Rullmann
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
- Integrated Research and Treatment Centre Adiposity Diseases Leipzig, Leipzig, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Leipzig, Germany
| | - Julia Luthardt
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Karsten Winter
- Centre for Translational Regenerative Medicine, University of Leipzig, Leipzig, Germany
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Mohammed K Hankir
- Integrated Research and Treatment Centre Adiposity Diseases Leipzig, Leipzig, Germany
| | - Georg-Alexander Becker
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Franziska Zientek
- Integrated Research and Treatment Centre Adiposity Diseases Leipzig, Leipzig, Germany
| | - Georg Reissig
- Integrated Research and Treatment Centre Adiposity Diseases Leipzig, Leipzig, Germany
| | - Ralf Regenthal
- Division of Clinical Pharmacology, Rudolf Boehm Institute of Pharmacology and Toxicology, University of Leipzig, Leipzig, Germany
| | - Mandy Drabe
- Integrated Research and Treatment Centre Adiposity Diseases Leipzig, Leipzig, Germany
| | | | - Anke Bresch
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Katrin Arelin
- Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Leipzig, Germany
- Day Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - Donald Lobsien
- Department of Neuroradiology, University of Leipzig, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Philipp M Meyer
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Mathias Fasshauer
- Integrated Research and Treatment Centre Adiposity Diseases Leipzig, Leipzig, Germany
- Medical Department III, University of Leipzig, Leipzig, Germany
| | - Wiebke K Fenske
- Integrated Research and Treatment Centre Adiposity Diseases Leipzig, Leipzig, Germany
- Medical Department III, University of Leipzig, Leipzig, Germany
| | - Matthias Blüher
- Medical Department III, University of Leipzig, Leipzig, Germany
- Collaborative Research Centre 1052 Obesity Mechanisms, University of Leipzig, Leipzig, Germany
| | - Michael Stumvoll
- Integrated Research and Treatment Centre Adiposity Diseases Leipzig, Leipzig, Germany
- Medical Department III, University of Leipzig, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
- Integrated Research and Treatment Centre Adiposity Diseases Leipzig, Leipzig, Germany
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