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Exploring the Mechanism of Yiqi Qingre Ziyin Method in Regulating Neuropeptide Expression for the Treatment of Atrophic Rhinitis. DISEASE MARKERS 2022; 2022:4416637. [PMID: 35299869 PMCID: PMC8923799 DOI: 10.1155/2022/4416637] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/29/2022] [Accepted: 02/09/2022] [Indexed: 01/18/2023]
Abstract
Atrophic rhinitis (AR) is a chronic disease that causes severe structural changes to the nasal mucosa leading to squamous epithelial metaplasia. However, treatment regarding AR remains a major challenge. We used network pharmacology and molecular docking methods to explore the potential mechanisms of the Yiqi Qingre Ziyin method to modulate neuropeptides in the treatment of AR. The active ingredients of the Yiqi Qingre Ziyin method and their targets of action were obtained from the Traditional Chinese Medicine Systematic Pharmacology Database Analysis Platform (TCMSP). Disease targets for AR were obtained from four databases: GeneCards, PharmGKB, DrugBank, and Online Mendelian Inheritance in Man (OMIM). A total of 59 active ingredients, 39 potential targets, and 76 relevant neuropeptides were obtained after deduplication. We constructed target interaction networks with the STRING database. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed on the 14 potential target proteins. We used Cytoscape software to construct the “drug-active ingredient-potential target” and “ingredient-target-pathway” networks of the Yiqi Qingre Ziyin method for treating AR. Molecular docking results suggest that dipeptidyl peptidase 4 (DPP4), opioid receptor gene d1 (OPRD1), and opioid receptor m1 (OPRM1) are key targets for the Yiqi Qingre Ziyin method. Therefore, this study proposed a potential mechanism for the treatment of AR by affecting the expression of neuropeptide-related genes (including DPP4, OPRD1, and OPRM1), which may potentially improve the immune microenvironment of the nasal mucosa.
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2
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Schwartz NE, Hecht LM, Haedt-Matt AA. Nutrition knowledge moderates the association between perfectionism and shape/weight concerns. Eur J Clin Nutr 2021; 75:1433-1439. [PMID: 33649527 DOI: 10.1038/s41430-021-00866-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/29/2020] [Accepted: 01/13/2021] [Indexed: 01/30/2023]
Abstract
Perfectionistic traits have been associated with stronger weight and diet concerns. Maladaptive perfectionism is tied to critical evaluation tendencies such as excessive concern about making mistakes, increasing one's risk for eating disorder pathology. Knowledge about healthy diet and nutrition may be one factor influencing associations between perfectionistic tendencies, as individuals with eating disorders may be more attuned to sources of nutrients. The current study examined whether nutrition knowledge moderates the association between one facet of perfectionism, concern over mistakes, and shape/weight concerns and the association between concern over mistakes and global eating pathology. College women (N = 122) completed questionnaires on disordered eating attitudes, nutrition knowledge, and perfectionism. Concern over mistakes was positively related to shape/weight concerns and global eating pathology. Nutrition knowledge significantly moderated the association between concerns over mistakes and shape/weight concerns, such that the association was stronger among those with higher levels of nutrition knowledge. Furthermore, nutrition knowledge displayed trend-level significance for the moderation of the association between concern over mistakes and global eating pathology. College women displaying high levels of concern over mistakes who are more informed about nutrition knowledge may be more vulnerable to developing concerns about body shape/weight and eating disorder pathology.
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Affiliation(s)
- Natalie E Schwartz
- Illinois Institute of Technology, 201 Tech Central, 3424 South State Street, Chicago, IL, 60616, USA.
| | - Leah M Hecht
- Illinois Institute of Technology, 201 Tech Central, 3424 South State Street, Chicago, IL, 60616, USA
| | - Alissa A Haedt-Matt
- Illinois Institute of Technology, 201 Tech Central, 3424 South State Street, Chicago, IL, 60616, USA
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3
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Chang X, Qu H, Liu Y, Glessner J, Hou C, Wang F, Li J, Sleiman P, Hakonarson H. Microduplications at the 15q11.2 BP1-BP2 locus are enriched in patients with anorexia nervosa. J Psychiatr Res 2019; 113:34-38. [PMID: 30878790 PMCID: PMC6486445 DOI: 10.1016/j.jpsychires.2019.01.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/14/2018] [Accepted: 01/25/2019] [Indexed: 11/16/2022]
Abstract
Microduplication at 15q11.2 have been reported in genetic association studies of schizophrenia and autism. Given the potential overlap in psychiatric symptoms of schizophrenia and autism with anorexia nervosa (AN), we were inspired to test the association of this CNV locus with the genetic susceptibility of AN using ParseCNV, a highly quality controlled CNV pipeline developed by our group. The CNV analysis was performed in 1017 AN cases and 7250 controls using the Illumina HumanHap610 SNP arrays data. We uncovered association of the 15q11.2 microduplication with AN with P = 0.00023, while no genetic association between the microdeletion of this region and AN was identified. Among four genes in this region that are not imprinted, NIPA1 has the highest expression in brain and encodes a magnesium transporter protein on early endosomes and the cell surface in neurons. Targeting at Mg2+ uptake mediated by NIPA1 presents an interesting research topic for the explorations of novel therapy for AN and other neurobehavioral diseases, such as schizophrenia and autism.
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Affiliation(s)
- Xiao Chang
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Huiqi Qu
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Yichuan Liu
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Joseph Glessner
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Cuiping Hou
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Fengxiang Wang
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Jin Li
- Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Patrick Sleiman
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA; Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA; Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Hakon Hakonarson
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA; Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA; Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
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4
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Duffy ME, Rogers ML, Joiner TE, Bergen AW, Berrettini W, Bulik CM, Brandt H, Crawford S, Crow S, Fichter M, Halmi K, Kaplan AS, Klump KL, Lilenfeld L, Magistretti PJ, Mitchell J, Schork NJ, Strober M, Thornton LM, Treasure J, Woodside B, Kaye WH, Keel PK. An investigation of indirect effects of personality features on anorexia nervosa severity through interoceptive dysfunction in individuals with lifetime anorexia nervosa diagnoses. Int J Eat Disord 2019; 52:200-205. [PMID: 30636025 DOI: 10.1002/eat.23008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 12/08/2018] [Accepted: 12/09/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study examined a hypothesized pathway by which interoceptive dysfunction accounted for associations between personality features (harm avoidance, self-directedness, and perfectionism) and anorexia nervosa (AN) severity (indicated by drive for thinness, eating disorder-related preoccupations and rituals, and body mass index). METHOD The study sample (n = 270, mean age = 28.47, 95.2% female, 98% White/Caucasian) consisted of probands and biological relatives who met DSM-IV criteria for lifetime diagnoses of AN (omitting criterion D, amenorrhea) drawn from the Price Foundation Anorexia Nervosa Affected Relative Pairs Study (AN-ARP). Participants completed measures assessing personality, interoceptive dysfunction, and eating pathology. RESULTS Associations between personality features of low self-directedness and high perfectionism and indicators of AN severity (drive for thinness and eating disorder-related preoccupations and rituals) were significant, as were the hypothesized indirect pathways through interoceptive dysfunction. Neither harm avoidance nor body mass index was significantly related to other study variables, and the proposed indirect pathways involving these variables were not significant. DISCUSSION Findings suggest that certain personality features may relate to AN severity, in part, through their associations with interoceptive dysfunction. Future research should examine prospective associations and the value of interventions targeting interoceptive dysfunction for interrupting the link between personality and AN severity.
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Affiliation(s)
- Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Andrew W Bergen
- BioRealm, LLC, Walnut, California.,Oregon Research Institute, Eugene, Oregon
| | - Wade Berrettini
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Scott Crow
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota.,The Emily Program, St. Paul, Minnesota
| | - Manfred Fichter
- Roseneck Hospital for Behavioral Medicine, affiliated with the University of Munich (LMU), Germany
| | - Katherine Halmi
- New York Presbyterian Hospital-Westchester Division, Weill Medical College of Cornell University, White Plains, New York
| | - Allan S Kaplan
- Centre for Addiction and Mental Health, Department of Psychiatry, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, Michigan
| | - Lisa Lilenfeld
- Department of Psychology, American School of Professional Psychology at Argosy University, Arlington, Virginia
| | - Pierre J Magistretti
- Department of Psychiatry, CHUY/University of Lausenne, Switzerland.,Brain Mind Institute, Switzerland
| | - James Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Nicholas J Schork
- Department of Quantitative Medicine, The Translational Genomics Research Institute, Phoenix, Arizona.,Human Biology, The J. Craig Venter Institute, La Jolla, California
| | - Michael Strober
- Department of Psychiatry, University of California Los Angeles, Los Angeles, California
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Blake Woodside
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Program for Eating Disorders, Toronto General Hospital, Toronto, Ontario, Canada
| | - Walter H Kaye
- Department of Psychiatry, University of California at San Diego, San Diego, California
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, Florida
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5
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Kanakam N, Krug I, Collier D, Treasure J. Altered Reward Reactivity as a Behavioural Endophenotype in Eating Disorders: A Pilot Investigation in Twins. EUROPEAN EATING DISORDERS REVIEW 2017; 25:195-204. [PMID: 28402067 DOI: 10.1002/erv.2512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 01/14/2017] [Accepted: 02/22/2017] [Indexed: 01/06/2023]
Abstract
Altered reward reactivity is a potential risk endophenotype for eating disorders (EDs). The aim of this study was to examine reward reactivity in female twins with EDs and compare it with a twin control group. A sample of 112 twins [n = 51 met lifetime DSM-IV ED criteria (anorexia nervosa n = 26; bulimic disorders n = 24), n = 19 unaffected cotwins and n = 42 control twins] was administered measures assessing reward reactivity, including the Game of Dice Task, the Behavioural Inhibition/Activation (BIS/BAS) Scales and the Appetitive Motivation Scale (AMS). Within pair, correlations for monozygotic and dizygotic twins were calculated and generalised estimating equations compared probands with non-ED cotwins and controls. The BAS and the AMS were reduced in EDs and negatively associated with restrictive symptoms. In addition, monozygotic twins pairs demonstrated significant within pair similarity for the BAS and AMS. Conversely, there was less evidence to support the BIS or risky decision-making as measured by the Game of Dice Task as an endophenotype in EDs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Natalie Kanakam
- Institute of Psychiatry, Eating Disorders Research Group, King's College London, London, UK
| | - Isabel Krug
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - David Collier
- Social, Genetic and Developmental Psychiatry Centre, London, UK
| | - Janet Treasure
- Institute of Psychiatry, Eating Disorders Research Group, King's College London, London, UK
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6
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Integrating multi-omics biomarkers and postprandial metabolism to develop personalized treatment for anorexia nervosa. Prostaglandins Other Lipid Mediat 2017; 132:69-76. [PMID: 28232135 DOI: 10.1016/j.prostaglandins.2017.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 01/26/2017] [Accepted: 02/02/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Anorexia Nervosa (AN) is a serious mental illness characterized by emaciation, an intense fear of gaining weight despite being underweight, and distorted body image. Few treatments reverse the core symptoms in AN such as profound aversion to food and food avoidance. Consequently, AN has a chronic and relapsing course and the highest mortality rate of any psychiatric illness. A more complete understanding of the disease pathogenesis is needed in order to develop better treatments and improve AN outcome. The pathogenesis and psychopathophysiology of AN can be better elucidated by combining longitudinal phenotyping with multiple "omics" techniques, including genomics, proteomics, lipidomics, and metabolomics. DESIGN This paper summarizes the key findings of a series of interrelated studies including new experimental data and previously published data, and describes our current initiatives and future directions. RESULTS Exon sequencing data was analyzed in 1205 AN and 1948 controls. Targeted metabolomics, lipidomics, and proteomics data were collected in two independent convenience samples consisting of 75 subjects with eating disorders and 61 sex- and age-matched healthy controls. Study participants were female and the mean age was 22.9 (4.9 [SD]) years. Epoxide hydrolase 2 (EPHX2) genetic variations were significantly associated with AN risk, and epoxide hydrolase (sEH) activity was elevated in AN compared to controls. The polyunsaturated fatty acids (PUFAs) and eicosanoids data revealed that cytochrome P450 pathway was implicated in AN, and AN displayed a dysregulated postprandial metabolism of PUFAs and sEH-dependent eicosanoids. IMPLICATION AND CURRENT INITIATIVES Collectively, our data suggest that dietary factors may contribute to the burden of EPHX2-associated AN susceptibility and affect disease outcome. We are implementing new investigations using a longitudinal study design in order to validate and develop an EPHX2 multi-omics biomarker system. We will test whether sEH-associated postprandial metabolism increases AN risk and affects treatment outcome through an ω-6 rich breakfast challenge. Participants will include 100 ill AN patients, 100 recovered AN patients, and 100 age- and race-matched healthy women. These data will allow us to investigate 1) how genetic and dietary factors independently and synergistically contribute to AN risk and progression, and 2) if clinical severity and treatment response in AN are affected by sEH activity and eicosanoid dysregulation. Results of our study will 1) identify clinically relevant biomarkers, 2) unravel mechanistic functions of sEH, and 3) delineate contributory roles of dietary PUFAs and cytochrome P450 pathway eicosanoids for the purpose of developing novel AN treatments and improving disease prognosis.
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7
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Crist RC, Clarke TK. OPRD1 Genetic Variation and Human Disease. Handb Exp Pharmacol 2016; 247:131-145. [PMID: 28035534 DOI: 10.1007/164_2016_112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
The OPRD1 gene encodes the delta-opioid receptor, which has multiple functions including regulating reward pathways. The gene contains more than 2,000 verified genetic variants but only 2 currently have evidence for specific functions: rs1042114 disrupts maturation of the receptor and rs569356 affects OPRD1 expression. These polymorphisms and others in the gene have been found to be associated with human diseases. The most reproducible data are associations between opioid addiction and three variants in intron 1 (rs2236861, rs2236857, and rs3766951), which have been described in a number of independent populations. Several publications also point toward an association between anorexia and a haplotype block containing rs569356 and rs533123. Unfortunately the mechanisms underlying these two effects are currently unknown. In contrast, rs1042114 has been linked to Alzheimer's disease through an increasingly well-defined mechanism by which the variant allele reduces production of the beta-amyloid plaques associated with the disease. Additional studies of OPRD1 variants are necessary to replicate current findings and to delineate the functional roles of relevant polymorphisms.
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Affiliation(s)
- Richard C Crist
- Center for Neurobiology and Behavior, Department of Psychiatry, University of Pennsylvania School of Medicine, 125 South 31st Street, Room 2207, Philadelphia, PA, 19104, USA.
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
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8
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Shih PAB, Woodside DB. Contemporary views on the genetics of anorexia nervosa. Eur Neuropsychopharmacol 2016; 26:663-73. [PMID: 26944296 PMCID: PMC4801707 DOI: 10.1016/j.euroneuro.2016.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 02/05/2016] [Accepted: 02/05/2016] [Indexed: 10/22/2022]
Abstract
Anorexia nervosa (AN) is a serious mental illness characterized by severe dietary restriction that leads to high rates of morbidity, chronicity, and mortality. Unfortunately, effective treatment is lacking and few options are available. High rates of familial aggregation and significant heritability suggested that the complex etiology of AN is affected by both genetic and environmental factors. In this paper, we review studies that reported common and rare genetic variation that influence susceptibility of AN through candidate gene studies, genome-wide association studies, and sequencing-based studies. We also discuss gene expression, methylation, imaging genetics, and pharmacogenetics to demonstrate that these studies have collectively advanced our knowledge of how genetic variation contributes to AN susceptibility and clinical course. Lastly, we highlight the importance of gene by environment interactions (G×E) and share our enthusiasm for the use of nutritional genomic approaches to elucidate the interaction among nutrients, metabolic intermediates, and genetic variation in AN. A deeper understanding of how nutrition alters genome stability, how genetic variation influences uptake and metabolism of nutrients, and how response to food components affects disordered eating, will lead to personalized dietary interventions and effective nutraceutical and pharmacological treatments for AN.
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Affiliation(s)
- Pei-an Betty Shih
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive #0664, La Jolla, CA 92093-0664, USA.
| | - D Blake Woodside
- Inpatient Eating Disorders Service, Toronto General Hospital, Canada; Department of Psychiatry, University of Toronto, Canada.
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9
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Guo Y, Wei Z, Keating BJ, Hakonarson H. Machine learning derived risk prediction of anorexia nervosa. BMC Med Genomics 2016; 9:4. [PMID: 26792494 PMCID: PMC4721143 DOI: 10.1186/s12920-016-0165-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 01/15/2016] [Indexed: 12/25/2022] Open
Abstract
Background Anorexia nervosa (AN) is a complex psychiatric disease with a moderate to strong genetic contribution. In addition to conventional genome wide association (GWA) studies, researchers have been using machine learning methods in conjunction with genomic data to predict risk of diseases in which genetics play an important role. Methods In this study, we collected whole genome genotyping data on 3940 AN cases and 9266 controls from the Genetic Consortium for Anorexia Nervosa (GCAN), the Wellcome Trust Case Control Consortium 3 (WTCCC3), Price Foundation Collaborative Group and the Children’s Hospital of Philadelphia (CHOP), and applied machine learning methods for predicting AN disease risk. The prediction performance is measured by area under the receiver operating characteristic curve (AUC), indicating how well the model distinguishes cases from unaffected control subjects. Results Logistic regression model with the lasso penalty technique generated an AUC of 0.693, while Support Vector Machines and Gradient Boosted Trees reached AUC’s of 0.691 and 0.623, respectively. Using different sample sizes, our results suggest that larger datasets are required to optimize the machine learning models and achieve higher AUC values. Conclusions To our knowledge, this is the first attempt to assess AN risk based on genome wide genotype level data. Future integration of genomic, environmental and family-based information is likely to improve the AN risk evaluation process, eventually benefitting AN patients and families in the clinical setting. Electronic supplementary material The online version of this article (doi:10.1186/s12920-016-0165-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yiran Guo
- The Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
| | - Zhi Wei
- Department of Computer Science, New Jersey Institute of Technology, Newark, NJ, 07102, USA
| | - Brendan J Keating
- The Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.,Department of Pediatrics, School of Medicine University of Pennsylvania, Philadelphia, PA, 19104, USA
| | | | | | | | - Hakon Hakonarson
- The Center for Applied Genomics, Abramson Research Center, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA. .,Department of Pediatrics, School of Medicine University of Pennsylvania, Philadelphia, PA, 19104, USA.
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10
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Kim YR, Kim JH, Kim CH, Shin JG, Treasure J. Association between the oxytocin receptor gene polymorphism (rs53576) and bulimia nervosa. EUROPEAN EATING DISORDERS REVIEW 2015; 23:171-8. [PMID: 25773927 DOI: 10.1002/erv.2354] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 01/21/2015] [Accepted: 02/13/2015] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Oxytocin circuits are implicated in the regulation of appetite and weight. Variants in the oxytocin receptor (OXTR) gene have been associated with bulimic behaviour. This study aimed to investigate the association between the OXTR gene and eating disorders. METHOD We genotyped six single nucleotide polymorphisms, rs53576, rs237879, rs2228485, rs13316193, rs2254298 and rs1042778, located within the OXTR gene in Korean patients with eating disorders using the single-base extension method. We studied a total of 262 women, including 69 patients with anorexia nervosa, 90 patients with bulimia nervosa (BN), and 103 healthy women. RESULTS We found a positive association between the G allele of OXTR rs53576 and BN. In the BN group, the G carriers showed a high score on the behavioural inhibition system. CONCLUSIONS These findings suggest the involvement of the oxytocinergic system in the mechanism that underlies BN.
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Affiliation(s)
- Youl-Ri Kim
- Department of Neuropsychiatry, Seoul Paik Hospital, Inje University College of Medicine, Seoul, South Korea; Institute of Eating Disorders and Mental Health, Inje University, Seoul, South Korea
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11
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Bennett SL, Gaudiani JL, Brinton JT, Mehler PS. Motivated to survive: high cooperativeness in severe anorexia nervosa. Eat Disord 2015; 23:430-8. [PMID: 25826097 DOI: 10.1080/10640266.2015.1027118] [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: 10/23/2022]
Abstract
This study assessed the personality of severely ill patients with anorexia nervosa, restricting (AN-R) and binge-purge subtypes (AN-BP), during hospitalization for medical stabilization. Participants (N = 37) completed the Temperament and Character Inventory, Revised. Personality domains were similar between AN-R and AN-BP with the exception of cooperativeness. AN-R patients scored higher on this dimension, suggesting that individuals with restricting anorexia may be more tolerant of treatment during early medical stabilization. Future research is needed to further elucidate this novel finding in order to identify the point at which body mass index predicts a decline in cooperativeness and the potential need for new intervention strategies.
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Affiliation(s)
- Susan L Bennett
- a Department of Psychiatry , University of Colorado Denver , Denver , Colorado , USA
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12
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Yilmaz Z, Kaplan AS, Tiwari AK, Levitan RD, Piran S, Bergen AW, Kaye WH, Hakonarson H, Wang K, Berrettini WH, Brandt HA, Bulik CM, Crawford S, Crow S, Fichter MM, Halmi KA, Johnson CL, Keel PK, Klump KL, Magistretti P, Mitchell JE, Strober M, Thornton LM, Treasure J, Woodside DB, Knight J, Kennedy JL. The role of leptin, melanocortin, and neurotrophin system genes on body weight in anorexia nervosa and bulimia nervosa. J Psychiatr Res 2014; 55:77-86. [PMID: 24831852 PMCID: PMC4191922 DOI: 10.1016/j.jpsychires.2014.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 03/05/2014] [Accepted: 04/04/2014] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Although low weight is a key factor contributing to the high mortality in anorexia nervosa (AN), it is unclear how AN patients sustain low weight compared with bulimia nervosa (BN) patients with similar psychopathology. Studies of genes involved in appetite and weight regulation in eating disorders have yielded variable findings, in part due to small sample size and clinical heterogeneity. This study: (1) assessed the role of leptin, melanocortin, and neurotrophin genetic variants in conferring risk for AN and BN; and (2) explored the involvement of these genes in body mass index (BMI) variations within AN and BN. METHOD Our sample consisted of 745 individuals with AN without a history of BN, 245 individuals with BN without a history of AN, and 321 controls. We genotyped 20 markers with known or putative function among genes selected from leptin, melanocortin, and neurotrophin systems. RESULTS There were no significant differences in allele frequencies among individuals with AN, BN, and controls. AGRP rs13338499 polymorphism was associated with lowest illness-related BMI in those with AN (p = 0.0013), and NTRK2 rs1042571 was associated with highest BMI in those with BN (p = 0.0018). DISCUSSION To our knowledge, this is the first study to address the issue of clinical heterogeneity in eating disorder genetic research and to explore the role of known or putatively functional markers in genes regulating appetite and weight in individuals with AN and BN. If replicated, our results may serve as an important first step toward gaining a better understanding of weight regulation in eating disorders.
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Affiliation(s)
- Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Clinical Research Department, Centre for Addiction and Mental Health, Toronto, Canada
| | - Allan S Kaplan
- Clinical Research Department, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Arun K Tiwari
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, Canada
| | - Robert D Levitan
- Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Mood and Anxiety Program, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sara Piran
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Andrew W Bergen
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Walter H Kaye
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Hakon Hakonarson
- Joseph Stokes Jr. Research Institute, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kai Wang
- Department of Psychiatry, University of Southern California, Los Angeles, CA, USA
| | - Wade H Berrettini
- Department of Psychiatry, Center of Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA, USA
| | - Harry A Brandt
- Department of Psychiatry, Sheppard Pratt Health System, Towson, MD, USA
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Steven Crawford
- Department of Psychiatry, Sheppard Pratt Health System, Towson, MD, USA
| | - Scott Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Manfred M Fichter
- Department of Psychiatry, University of Munich (LMU), Munich, Germany; Roseneck Hospital for Behavioral Medicine, Prien, Germany
| | - Katherine A Halmi
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | | | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Pierre Magistretti
- Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - James E Mitchell
- Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA; Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Michael Strober
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Janet Treasure
- Department of Academic Psychiatry, King's College London, Institute of Psychiatry, London, United Kingdom
| | - D Blake Woodside
- Department of Psychiatry, University of Toronto, Toronto, Canada; Eating Disorders Program, Toronto General Hospital, Toronto, Canada
| | - Joanne Knight
- Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, Canada
| | - James L Kennedy
- Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, Canada.
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13
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Baker JH, Sisk CL, Thornton LM, Brandt H, Crawford S, Fichter MM, Halmi KA, Johnson C, Jones I, Kaplan AS, Mitchell JE, Strober M, Treasure J, Woodside DB, Berrettini WH, Kaye WH, Bulik CM, Klump KL. Primary amenorrhea in anorexia nervosa: impact on characteristic masculine and feminine traits. EUROPEAN EATING DISORDERS REVIEW 2014; 22:32-8. [PMID: 24123541 PMCID: PMC4266542 DOI: 10.1002/erv.2263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 07/10/2013] [Accepted: 09/10/2013] [Indexed: 11/09/2022]
Abstract
Animal studies indicate that gonadal hormones at puberty have an effect on the development of masculine and feminine traits. However, it is unknown whether similar processes occur in humans. We examined whether women with anorexia nervosa (AN), who often experience primary amenorrhea, exhibit attenuated feminization in their psychological characteristics in adulthood due to the decrease/absence of gonadal hormones at puberty. Women with AN were compared on a number of psychological characteristics using general linear models on the basis of the presence/absence of primary amenorrhea. Although women with primary amenorrhea exhibited lower anxiety scores than those without primary amenorrhea, in general, results did not provide evidence of attenuated feminization in women with AN with primary amenorrhea. Future research should utilize novel techniques and direct hormone measurement to explore the effects of pubertal gonadal hormones on masculine and feminine traits.
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14
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Abstract
Disordered eating behavior is the core symptom of the complex disorders anorexia nervosa and bulimia nervosa. Twin and family studies derive high heritability estimates. Hence, substantial genetic influences on the etiology can be assumed for both. Initially, candidate gene studies pertaining to the monoaminergic neurotransmitter systems and to body weight regulation comprised the core of the genetic analyses. Unfortunately, confirmed, solid findings substantiated in meta-analyses are rare, so that eventually none of these associations is unequivocal. Thus, systematic, genome-wide approaches emerged to identify genes with no a priori evidence for their involvement in eating disorders. Genome-wide association studies have hinted to formerly unknown genetic regions. However, significant genome-wide findings have not yet been reported.
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15
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Cui H, Moore J, Ashimi SS, Mason BL, Drawbridge JN, Han S, Hing B, Matthews A, McAdams CJ, Darbro BW, Pieper AA, Waller DA, Xing C, Lutter M. Eating disorder predisposition is associated with ESRRA and HDAC4 mutations. J Clin Invest 2013; 123:4706-13. [PMID: 24216484 PMCID: PMC3809805 DOI: 10.1172/jci71400] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 08/08/2013] [Indexed: 12/22/2022] Open
Abstract
Anorexia nervosa and bulimia nervosa are common and severe eating disorders (EDs) of unknown etiology. Although genetic factors have been implicated in the psychopathology of EDs, a clear biological pathway has not been delineated. DNA from two large families affected by EDs was collected, and mutations segregating with illness were identified by whole-genome sequencing following linkage mapping or by whole-exome sequencing. In the first family, analysis of twenty members across three generations identified a rare missense mutation in the estrogen-related receptor α (ESRRA) gene that segregated with illness. In the second family, analysis of eight members across four generations identified a missense mutation in the histone deacetylase 4 (HDAC4) gene that segregated with illness. ESRRA and HDAC4 were determined to interact both in vitro in HeLa cells and in vivo in mouse cortex. Transcriptional analysis revealed that HDAC4 potently represses the expression of known ESRRA-induced target genes. Biochemical analysis of candidate mutations revealed that the identified ESRRA mutation decreased its transcriptional activity, while the HDAC4 mutation increased transcriptional repression of ESRRA. Our findings suggest that mutations that result in decreased ESRRA activity increase the risk of developing EDs.
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Affiliation(s)
- Huxing Cui
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jarrette Moore
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sunbola S. Ashimi
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Brittany L. Mason
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jordan N. Drawbridge
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Shizhong Han
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Benjamin Hing
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Abigail Matthews
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Carrie J. McAdams
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Benjamin W. Darbro
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Andrew A. Pieper
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - David A. Waller
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Chao Xing
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michael Lutter
- Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Pediatrics and
Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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16
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Zerwas S, Lund BC, Von Holle A, Thornton LM, Berrettini WH, Brandt H, Crawford S, Fichter MM, Halmi KA, Johnson C, Kaplan AS, La Via M, Mitchell J, Rotondo A, Strober M, Woodside DB, Kaye WH, Bulik CM. Factors associated with recovery from anorexia nervosa. J Psychiatr Res 2013; 47:972-9. [PMID: 23535032 PMCID: PMC3682792 DOI: 10.1016/j.jpsychires.2013.02.011] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 02/20/2013] [Accepted: 02/24/2013] [Indexed: 11/20/2022]
Abstract
Previous studies of prognostic factors of anorexia nervosa (AN) course and recovery have followed clinical populations after treatment discharge. This retrospective study examined the association between prognostic factors--eating disorder features, personality traits, and psychiatric comorbidity--and likelihood of recovery in a large sample of women with AN participating in a multi-site genetic study. The study included 680 women with AN. Recovery was defined as the offset of AN symptoms if the participant experienced at least one year without any eating disorder symptoms of low weight, dieting, binge eating, and inappropriate compensatory behaviors. Participants completed a structured interview about eating disorders features, psychiatric comorbidity, and self-report measures of personality. Survival analysis was applied to model time to recovery from AN. Cox regression models were used to fit associations between predictors and the probability of recovery. In the final model, likelihood of recovery was significantly predicted by the following prognostic factors: vomiting, impulsivity, and trait anxiety. Self-induced vomiting and greater trait anxiety were negative prognostic factors and predicted lower likelihood of recovery. Greater impulsivity was a positive prognostic factor and predicted greater likelihood of recovery. There was a significant interaction between impulsivity and time; the association between impulsivity and likelihood of recovery decreased as duration of AN increased. The anxiolytic function of some AN behaviors may impede recovery for individuals with greater trait anxiety.
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Affiliation(s)
- Stephanie Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7160, USA.
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17
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Baker JH, Thornton LM, Strober M, Brandt H, Crawford S, Fichter MM, Halmi KA, Johnson C, Jones I, Kaplan AS, Klump KL, Mitchell JE, Treasure J, Woodside DB, Berrettini WH, Kaye WH, Bulik CM. Temporal sequence of comorbid alcohol use disorder and anorexia nervosa. Addict Behav 2013; 38:1704-9. [PMID: 23254222 DOI: 10.1016/j.addbeh.2012.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 08/14/2012] [Accepted: 10/03/2012] [Indexed: 11/16/2022]
Abstract
Women with eating disorders have a significantly higher prevalence of substance use disorders than the general population. The goal of the current study was to assess the temporal pattern of comorbid anorexia nervosa (AN) and alcohol use disorder (AUD) and the impact this ordering has on symptomatology and associated features. Women were placed into one of three groups based on the presence or absence of comorbid AUD and the order of AN and AUD onset in those with both disorders: (1) AN Only, (2) AN First, and (3) AUD First. The groups were compared on psychological symptoms and personality characteristics often associated with AN, AUD, or both using general linear models. Twenty-one percent of women (n=161) with AN reported a history of AUD with 115 reporting AN onset first and 35 reporting AUD onset first. Women with binge-eating and/or purging type AN were significantly more likely to have AUD. In general, differences were found only between women with AN Only and women with AN and AUD regardless of order of emergence. Women with AN and AUD had higher impulsivity scores and higher prevalence of depression and borderline personality disorder than women with AN Only. Women with AN First scored higher on traits commonly associated with AN, whereas women with comorbid AN and AUD displayed elevations in traits more commonly associated with AUD. Results do not indicate a distinct pattern of symptomatology in comorbid AN and AUD based on the temporal sequence of the disorders.
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Affiliation(s)
- Jessica H Baker
- 101 Manning Drive, CB #7160, Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599, United States
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18
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Taborelli E, Krug I, Karwautz A, Wagner G, Haidvogl M, Fernandez-Aranda F, Castro R, Jiménez-Murcia S, Anderluh M, Collier D, Treasure JL, Micali N. Maternal Anxiety, Overprotection and Anxious Personality as Risk Factors for Eating Disorder: A Sister Pair Study. COGNITIVE THERAPY AND RESEARCH 2013. [DOI: 10.1007/s10608-012-9518-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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19
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Slof-Op ‘t Landt MCT, van Furth EF, Meulenbelt I, Slagboom PE, Bartels M, Boomsma DI, Bulik CM. Eating Disorders: From Twin Studies to Candidate Genes and Beyond. Twin Res Hum Genet 2012. [DOI: 10.1375/twin.8.5.467] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractSubstantial effort has been put into the exploration of the biological background of eating disorders, through family, twin and molecular genetic studies. Family studies have shown that anorexia (AN) and bulimia nervosa (BN) are strongly familial, and that familial etiologic factors appear to be shared by both disorders. Twin studies often focus on broader phenotypes or subthreshold eating disorders. These studies consistently yielded moderate to substantial heritabilities. In addition, there has been a proliferation of molecular genetic studies that focused on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) AN and BN. Seven linkage regions have been identified in genome-wide screens. Many genetic association studies have been performed, but no consistent association between a candidate gene and AN or BN has been reported. Larger genetic association studies and collaborations are needed to examine the involvement of several candidate genes and biological pathways in eating disorders. In addition, twin studies should be designed to assist the molecular work by further exploring genetic determinants of endophenotypes, evaluating the magnitude of contribution to liability of measured genotypes as well as environmental risk factors related to eating disorders. In this manner twin and molecular studies can move the field forward in a mutually informative way.
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20
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Affiliation(s)
- Stephanie Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Cynthia M Bulik
- Department of Psychiatry and Department of Nutrition, University of North Carolina at Chapel Hill
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21
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Bulik CM, Tozzi F. Contemporary thinking about the role of genes and environment in eating disorders. ACTA ACUST UNITED AC 2011; 13:91-8. [PMID: 15298318 DOI: 10.1017/s1121189x00003316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SummaryObjective – To review recent literature documenting how family, twin and molecular genetic studies of eating disorders have revolutionized our conceptualizations of anorexia and bulimia nervosa. Methods – We summarized extant litera-ture on genetic epidemiology of eating disorders. Results – Results of extant studies highlight the underlying biological vulnera- bilities associated with these conditions. Genetic research has also opened up new avenues and approaches for exploring how the environment exerts its influence on risk. Conclusions – We discuss state-of-the-science findings in the genetics of eating disorders, explore various mechanisms of gene-environment interplay, and discuss implications of this research for science, practice, families and individuals with eating disorders.
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Affiliation(s)
- Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7160, USA.
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22
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Bloss CS, Berrettini W, Bergen AW, Magistretti P, Duvvuri V, Strober M, Brandt H, Crawford S, Crow S, Fichter MM, Halmi KA, Johnson C, Kaplan AS, Keel P, Klump KL, Mitchell J, Treasure J, Woodside DB, Marzola E, Schork NJ, Kaye WH. Genetic association of recovery from eating disorders: the role of GABA receptor SNPs. Neuropsychopharmacology 2011; 36:2222-32. [PMID: 21750581 PMCID: PMC3176559 DOI: 10.1038/npp.2011.108] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Follow-up studies of eating disorders (EDs) suggest outcomes ranging from recovery to chronic illness or death, but predictors of outcome have not been consistently identified. We tested 5151 single-nucleotide polymorphisms (SNPs) in approximately 350 candidate genes for association with recovery from ED in 1878 women. Initial analyses focused on a strictly defined discovery cohort of women who were over age 25 years, carried a lifetime diagnosis of an ED, and for whom data were available regarding the presence (n=361 ongoing symptoms in the past year, ie, 'ill') or absence (n=115 no symptoms in the past year, ie, 'recovered') of ED symptoms. An intronic SNP (rs17536211) in GABRG1 showed the strongest statistical evidence of association (p=4.63 × 10(-6), false discovery rate (FDR)=0.021, odds ratio (OR)=0.46). We replicated these findings in a more liberally defined cohort of women age 25 years or younger (n=464 ill, n=107 recovered; p=0.0336, OR=0.68; combined sample p=4.57 × 10(-6), FDR=0.0049, OR=0.55). Enrichment analyses revealed that GABA (γ-aminobutyric acid) SNPs were over-represented among SNPs associated at p<0.05 in both the discovery (Z=3.64, p=0.0003) and combined cohorts (Z=2.07, p=0.0388). In follow-up phenomic association analyses with a third independent cohort (n=154 ED cases, n=677 controls), rs17536211 was associated with trait anxiety (p=0.049), suggesting a possible mechanism through which this variant may influence ED outcome. These findings could provide new insights into the development of more effective interventions for the most treatment-resistant patients.
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Affiliation(s)
- Cinnamon S Bloss
- Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health, La Jolla, CA, USA
| | - Wade Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew W Bergen
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Pierre Magistretti
- Brain Mind Institute, EPFL and Department of Psychiatry, University of Lausanne Medical School, Lausanne, Switzerland
| | - Vikas Duvvuri
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Harry Brandt
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Steve Crawford
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Scott Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Manfred M Fichter
- Roseneck Hospital for Behavioral Medicine, Prien, Germany and Department of Psychiatry, University of Munich (LMU), Munich, Germany
| | - Katherine A Halmi
- New York Presbyterian Hospital-Westchester Division, Weill Medical College of Cornell University, White Plains, NY, USA
| | - Craig Johnson
- Laureate Psychiatric Clinic and Hospital, Tulsa, OK, USA
| | - Allan S Kaplan
- Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,Department of Psychiatry, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Pamela Keel
- Department of Psychology, Florida State University, Tallahasseei, FL, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - James Mitchell
- Neuropsychiatric Research Institute, Fargo, ND, USA,Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - Janet Treasure
- Eating Disorders Section, Institute of Psychiatry, King's College, University of London, London, UK
| | - D Blake Woodside
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada,Department of Psychiatry, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Enrica Marzola
- Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health, La Jolla, CA, USA,Day Hospital of the Eating Disorders Program at the San Giovanni Battista Hospital of Turin, Turin, Italy
| | - Nicholas J Schork
- Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health, La Jolla, CA, USA,Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA,Scripps Genomic Medicine, Scripps Translational Science Institute, 3344 North Torrey Pines Court, Suite 300, La Jolla, CA 92037, USA. Tel: +1 858 554 5705, E-mail:
| | - Walter H Kaye
- Department of Psychiatry, University of California, San Diego, CA, USA,Department of Psychiatry, University of California, San Diego, 8950 Villa La Jolla Drive, Suite C207, La Jolla, CA 92037, USA. Tel: +1 858 205 7293; Fax: +1 858 534 6727, E-mail:
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23
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Wang K, Zhang H, Bloss CS, Duvvuri V, Kaye W, Schork NJ, Berrettini W, Hakonarson H. A genome-wide association study on common SNPs and rare CNVs in anorexia nervosa. Mol Psychiatry 2011; 16:949-59. [PMID: 21079607 DOI: 10.1038/mp.2010.107] [Citation(s) in RCA: 135] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Anorexia nervosa (AN) is a mental illness with high mortality that most commonly afflicts adolescent female individuals. Clinical symptoms include chronic food refusal, weight loss and body image distortions. We carried out a genome-wide association study on 1033 AN cases and 3733 pediatric control subjects, all of whom were of European ancestry and were genotyped on the Illumina HumanHap610 platform (Illumina, San Diego, CA, USA). We confirmed that common single-nucleotide polymorphisms (SNPs) within OPRD1 (rs533123, P=0.0015) confer risk for AN, and obtained suggestive evidence that common SNPs near HTR1D (rs7532266, P=0.04) confer risk for restricting-type AN specifically. However, no SNPs reached genome-wide significance in our data, whereas top association signals were detected near ZNF804B, CSRP2BP, NTNG1, AKAP6 and CDH9. In parallel, we performed genome-wide analysis on copy number variations (CNVs) using the signal intensity data from the SNP arrays. We did not find evidence that AN cases have more CNVs than control subjects, nor do they have over-representation of rare or large CNVs. However, we identified several regions with rare CNVs that were only observed in AN cases, including a recurrent 13q12 deletion (1.5 Mb) disrupting SCAS in two cases, and CNVs disrupting the CNTN6/CNTN4 region in several AN cases. In conclusion, our study suggests that both common SNPs and rare CNVs may confer genetic risk to AN. These results point to intriguing genes that await further validation in independent cohorts for confirmatory roles in AN.
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Affiliation(s)
- K Wang
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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24
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Root TL, Szatkiewicz JP, Jonassaint CR, Thornton LM, Pinheiro AP, Strober M, Bloss C, Berrettini W, Schork NJ, Kaye WH, Bergen AW, Magistretti P, Brandt H, Crawford S, Crow S, Fichter MM, Goldman D, Halmi KA, Johnson C, Kaplan AS, Keel PK, Klump KL, La Via M, Mitchell JE, Rotondo A, Treasure J, Woodside DB, Bulik CM. Association of candidate genes with phenotypic traits relevant to anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2011; 19:487-93. [PMID: 21780254 DOI: 10.1002/erv.1138] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 05/06/2011] [Accepted: 05/15/2011] [Indexed: 11/09/2022]
Abstract
This analysis is a follow-up to an earlier investigation of 182 genes selected as likely candidate genetic variations conferring susceptibility to anorexia nervosa (AN). As those initial case-control results revealed no statistically significant differences in single nucleotide polymorphisms, herein, we investigate alternative phenotypes associated with AN. In 1762 females, using regression analyses, we examined the following: (i) lowest illness-related attained body mass index; (ii) age at menarche; (iii) drive for thinness; (iv) body dissatisfaction; (v) trait anxiety; (vi) concern over mistakes; and (vii) the anticipatory worry and pessimism versus uninhibited optimism subscale of the harm avoidance scale. After controlling for multiple comparisons, no statistically significant results emerged. Although results must be viewed in the context of limitations of statistical power, the approach illustrates a means of potentially identifying genetic variants conferring susceptibility to AN because less complex phenotypes associated with AN are more proximal to the genotype and may be influenced by fewer genes.
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Affiliation(s)
- Tammy L Root
- Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, MD, USA
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25
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Jonassaint CR, Szatkiewicz JP, Bulik CM, Thornton LM, Bloss C, Berrettini W, Kaye WH, Bergen AW, Magistretti P, Strober M, Keel PK, Brandt H, Crawford S, Crow S, Fichter MM, Goldman D, Halmi KA, Johnson C, Kaplan AS, Klump KL, La Via M, Mitchell J, Rotondo A, Treasure J, Woodside DB. Absence of association between specific common variants of the obesity-related FTO gene and psychological and behavioral eating disorder phenotypes. Am J Med Genet B Neuropsychiatr Genet 2011; 156B:454-61. [PMID: 21438147 PMCID: PMC3249222 DOI: 10.1002/ajmg.b.31182] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Accepted: 02/24/2011] [Indexed: 11/08/2022]
Abstract
Extensive population-based genome-wide association studies have identified an association between the FTO gene and BMI; however, the mechanism of action is still unknown. To determine whether FTO may influence weight regulation through psychological and behavioral factors, seven single-nucleotide polymorphisms (SNPs) of the FTO gene were genotyped in 1,085 individuals with anorexia nervosa (AN) and 677 healthy weight controls from the international Price Foundation Genetic Studies of Eating Disorders. Each SNP was tested in association with eating disorder phenotypes and measures that have previously been associated with eating behavior pathology: trait anxiety, harm-avoidance, novelty seeking, impulsivity, obsessionality, compulsivity, and concern over mistakes. After appropriate correction for multiple comparisons, no significant associations between individual FTO gene SNPs and eating disorder phenotypes or related eating behavior pathology were identified in cases or controls. Thus, this study found no evidence that FTO gene variants associated with weight regulation in the general population are associated with eating disorder phenotypes in AN participants or matched controls.
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Affiliation(s)
| | - Jin Peng Szatkiewicz
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Cinnamon Bloss
- Scripps Genomic Medicine, The Scripps Research Institute, La Jolla, California
| | - Wade Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Walter H. Kaye
- Department of Psychiatry, University of California at San Diego, San Diego, CA
| | | | - Pierre Magistretti
- Brain Mind Institute EPFL – Lausanne and Center for Psychiatric Neuroscience, Department of Psychiatry, University of Lausanne Medical School, Lausanne, Switzerland
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Harry Brandt
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Steve Crawford
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Scott Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Manfred M. Fichter
- Roseneck Hospital for Behavioral Medicine, Prien, Germany and Department of Psychiatry, University of Munich (LMU), Munich, Germany
| | - David Goldman
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD
| | - Katherine A. Halmi
- New York Presbyterian Hospital-Westchester Division, Weill Medical College of Cornell University, White Plains, NY
| | | | - Allan S. Kaplan
- Centre for Addiction and Mental Health, Toronto, Canada,Department of Psychiatry, University of Toronto, Toronto, Canada,Department of Psychiatry, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, East Lansing, MI
| | - Maria La Via
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - James Mitchell
- Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Alessandro Rotondo
- Neuropsychiatric Research Biotechnologies, University of Pisa, Pisa, Italy
| | - Janet Treasure
- Eating Disorders Section, Institute of Psychiatry, King’s College, University of London, England
| | - D. Blake Woodside
- Department of Psychiatry, University of Toronto, Toronto, Canada,Department of Psychiatry, Toronto General Hospital, University Health Network, Toronto, Canada
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Impact of broadening definitions of anorexia nervosa on sample characteristics. J Psychiatr Res 2011; 45:691-8. [PMID: 20974478 PMCID: PMC3033482 DOI: 10.1016/j.jpsychires.2010.10.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 09/28/2010] [Accepted: 10/05/2010] [Indexed: 11/23/2022]
Abstract
Practical limitations and sample size considerations often lead to broadening of diagnostic criteria for anorexia nervosa (AN) in research. The current study sought to elucidate the effects of this practice on resultant sample characteristics in terms of eating disorder behaviors, psychiatric comorbidities, temperament and personality characteristics, and heritability point estimates. Three definitions of AN were created: meeting all Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for AN (AN-DSM-IV), meeting all DSM-IV criteria except criterion D, amenorrhea, (AN-noD), and broadening DSM-IV AN criteria by allowing a higher body mass index value, eliminating criterion D, and allowing less stringent body weight concerns (AN-Broad). Using data from the Swedish Twin Registry, 473 women fit one of the three definitions of AN. Women with AN-DSM-IV reported significantly more eating disorder behaviors than women with AN-Broad. Women with AN-noD reported more comorbid psychiatric disorders than women with AN-DSM-IV and AN-Broad. Temperament and personality characteristics did not differ across the three groups. Heritability point estimates decreased as AN definition broadened. Broadening the diagnostic criteria for AN results in an increased number of individuals available for participation in research studies. However, broader criteria for AN yield a more heterogeneous sample with regard to eating disorder symptoms and psychiatric comorbidity than a sample defined by narrower criteria.
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27
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Kim YR, Kim JE, Kim MH. Impaired Set-Shifting Ability in Patients with Eating Disorders, Which Is Not Moderated by Their Catechol-O-Methyltransferase Val158Met Genotype. Psychiatry Investig 2010; 7:298-301. [PMID: 21253415 PMCID: PMC3022318 DOI: 10.4306/pi.2010.7.4.298] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Revised: 08/06/2010] [Accepted: 09/03/2010] [Indexed: 01/05/2023] Open
Abstract
The aim of this study was to examine the set-shifting ability in women with both anorexia nervosa (AN) and bulimia nervosa (BN) and to investigate whether it is contributed by the catechol-O-methyltransferase (COMT) Val158Met genotype. A total of 102 Korean participants-40 women with lifetime AN, 28 women with lifetime BN, and 34 healthy women of comparable age and intelligence quotient- were examined. A neuropsychological battery of tests was applied and blood samples were obtained for COMT Val158Met genotyping. Set-shifting impairments Trail Making Test (TMT, Part B) were found in patients with AN and BN, respectively. Furthermore, the eating disorders were also linked to deficits in attentional mechanisms (TMT, Part A) and motor skills (Finger Tapping Test). Finally, set-shifting and its link to eating disorders were not moderated by COMT Val158Met genotype.
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Affiliation(s)
- Youl-Ri Kim
- Department of Neuropsychiatry, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Ji Eun Kim
- Department of Neuropsychiatry, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Mi Hyun Kim
- Department of Neuropsychiatry, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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28
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Kim YR, Heo SY, Kang H, Song KJ, Treasure J. Childhood risk factors in Korean women with anorexia nervosa: two sets of case-control studies with retrospective comparisons. Int J Eat Disord 2010; 43:589-95. [PMID: 19806610 DOI: 10.1002/eat.20752] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the characteristics of the risk factors for anorexia nervosa (AN) in Korean women. METHOD Two sets of case-control comparisons were conducted, in which 52 women with lifetime AN from Seoul, S. Korea, were compared with 108 Korean healthy controls and also with 42 women with lifetime AN from the UK in terms of their childhood risk factors. A questionnaire designed to conduct a retrospective assessment of the childhood risk factors was administered to all participants. RESULTS The Korean AN women were more likely to report premorbid anxiety, perfectionism, and emotional undereating and were less likely to report having supportive figures in their childhood than the Korean healthy controls. There were no overall differences in the childhood risk factors between the Korean and British women with AN. DISCUSSION Premorbid anxiety, perfectionism, less social support, and emotional undereating merit attention as risk factors in Korean AN. The current results are informative, but an epidemiologically robust prospective case-control study would be needed to validate these findings.
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Affiliation(s)
- Youl-Ri Kim
- Eating Disorders Clinic, Department of Neuropsychiatry, Seoul-Paik Hospital, Inje University, Seoul, S. Korea.
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29
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Pinheiro AP, Bulik CM, Thornton LM, Sullivan PF, Root TL, Bloss CS, Berrettini WH, Schork NJ, Kaye WH, Bergen AW, Magistretti P, Brandt H, Crawford S, Crow S, Fichter MM, Goldman D, Halmi KA, Johnson C, Kaplan AS, Keel PK, Klump KL, La Via M, Mitchell JE, Strober M, Rotondo A, Treasure J, Woodside DB. Association study of 182 candidate genes in anorexia nervosa. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:1070-80. [PMID: 20468064 PMCID: PMC2963154 DOI: 10.1002/ajmg.b.31082] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
We performed association studies with 5,151 SNPs that were judged as likely candidate genetic variations conferring susceptibility to anorexia nervosa (AN) based on location under reported linkage peaks, previous results in the literature (182 candidate genes), brain expression, biological plausibility, and estrogen responsivity. We employed a case-control design that tested each SNP individually as well as haplotypes derived from these SNPs in 1,085 case individuals with AN diagnoses and 677 control individuals. We also performed separate association analyses using three increasingly restrictive case definitions for AN: all individuals with any subtype of AN (All AN: n = 1,085); individuals with AN with no binge eating behavior (AN with No Binge Eating: n = 687); and individuals with the restricting subtype of AN (Restricting AN: n = 421). After accounting for multiple comparisons, there were no statistically significant associations for any individual SNP or haplotype block with any definition of illness. These results underscore the importance of large samples to yield appropriate power to detect genotypic differences in individuals with AN and also motivate complementary approaches involving Genome-Wide Association (GWA) studies, Copy Number Variation (CNV) analyses, sequencing-based rare variant discovery assays, and pathway-based analysis in order to make up for deficiencies in traditional candidate gene approaches to AN.
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Affiliation(s)
- Andrea Poyastro Pinheiro
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,Correspondence to: Dr. Cynthia M. Bulik, Ph.D., Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599 -7160.
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Patrick F. Sullivan
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Tammy L. Root
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cinnamon S. Bloss
- Scripps Genomic Medicine, The Scripps Research Institute, La Jolla, California
| | - Wade H. Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nicholas J. Schork
- Scripps Genomic Medicine, The Scripps Research Institute, La Jolla, California
| | - Walter H. Kaye
- Department of Psychiatry, University of California at San Diego, San Diego, California,Correspondence to: Dr. Walter H. Kaye, M.D., Department of Psychiatry, University of California San Diego, 8950 Villa La Jolla Dr., Suite C207, La Jolla, CA 92037.
| | - Andrew W. Bergen
- Center for Health Sciences, SRI International, Menlo Park, California
| | - Pierre Magistretti
- Department of Psychiatry, Brain Mind Institute EPFL—Lausanne, Center for Psychiatric Neuroscience, University of Lausanne Medical School, Lausanne, Switzerland
| | - Harry Brandt
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Steve Crawford
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Scott Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Manfred M. Fichter
- Roseneck Hospital for Behavioral Medicine, Prien, Germany, Department of Psychiatry, University of Munich (LMU), Munich, Germany
| | - David Goldman
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Katherine A. Halmi
- New York Presbyterian Hospital, Westchester Division, Weill Medical College of Cornell University, White Plains, New York
| | - Craig Johnson
- Laureate Psychiatric Clinic and Hospital, Tulsa, Oklahoma
| | - Allan S. Kaplan
- Center for Addiction and Mental Health, Toronto, Canada, Department of Psychiatry, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, East Lansing, Michigan
| | - Maria La Via
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - James E. Mitchell
- Neuropsychiatric Research Institute, Fargo, North Dakota, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Alessandro Rotondo
- Neuropsychiatric Research Biotechnologies, University of Pisa, Pisa, Italy
| | - Janet Treasure
- Eating Disorders Section, Institute of Psychiatry, King’s College, University of London, London, England
| | - D. Blake Woodside
- Center for Addiction and Mental Health, Toronto, Canada, Department of Psychiatry, Toronto General Hospital, University Health Network, Toronto, Canada, Department of Psychiatry, University of Toronto, Toronto, Canada
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30
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Pinheiro AP, Raney TJ, Thornton LM, Fichter MM, Berrettini WH, Goldman D, Halmi KA, Kaplan AS, Strober M, Treasure J, Woodside DB, Kaye WH, Bulik CM. Sexual functioning in women with eating disorders. Int J Eat Disord 2010; 43:123-9. [PMID: 19260036 PMCID: PMC2820601 DOI: 10.1002/eat.20671] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To describe sexual functioning in women with eating disorders. METHOD We assessed physical intimacy, libido, sexual anxiety, partner status, and sexual relationships in 242 women from the International Price Foundation Genetic Studies relative to normative data. RESULTS Intercourse (55.3%), having a partner (52.7%), decreased sexual desire (66.9%), and increased sexual anxiety (59.2%) were common. Women with restricting and purging anorexia nervosa had a higher prevalence of loss of libido than women with bulimia nervosa and eating disorder not otherwise specified (75%, 74.6%, 39%, and 45.4%, respectively). Absence of sexual relationships was associated with lower minimum lifetime body mass index (BMI) and earlier age of onset; loss of libido with lower lifetime BMI, higher interoceptive awareness and trait anxiety; and sexual anxiety with lower lifetime BMI, higher harm avoidance and ineffectiveness. Sexual dysfunction in eating disorders was higher than in the normative sample. DISCUSSION Sexual dysfunction is common across eating disorders subtypes. Low BMI is associated with loss of libido, sexual anxiety, and avoidance of sexual relationships.
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Affiliation(s)
| | - TJ Raney
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC
| | - Manfred M. Fichter
- Department of Psychiatry, University of Munich (LMU), Munich, Germany, and Roseneck Hospital for Behavioral Medicine, Prien, Germany
| | - Wade H. Berrettini
- Center of Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA
| | - David Goldman
- National Institute of Alcohol Abuse and Alcoholism, Rockville, MD
| | - Katherine A. Halmi
- New York Presbyterian Hospital-Westchester Division, Weill Medical College of Cornell University, White Plains, NY
| | - Allan S. Kaplan
- Department of Psychiatry, The Toronto Hospital, Toronto, Canada
| | - Michael Strober
- Semel Institute for Neuroscience, University of California at Los Angeles, Los Angeles, CA
| | | | | | - Walter H. Kaye
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, Department of Psychiatry, University of California at San Diego, San Diego, CA
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC
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31
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Eating disorders: the current status of molecular genetic research. Eur Child Adolesc Psychiatry 2010; 19:211-26. [PMID: 20033240 PMCID: PMC2839487 DOI: 10.1007/s00787-009-0085-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Accepted: 12/04/2009] [Indexed: 12/31/2022]
Abstract
Anorexia nervosa (AN) and bulimia nervosa (BN) are complex disorders characterized by disordered eating behavior where the patient's attitude towards weight and shape, as well as their perception of body shape, are disturbed. Formal genetic studies on twins and families suggested a substantial genetic influence for AN and BN. Candidate gene studies have initially focused on the serotonergic and other central neurotransmitter systems and on genes involved in body weight regulation. Hardly any of the positive findings achieved in these studies were unequivocally confirmed or substantiated in meta-analyses. This might be due to too small sample sizes and thus low power and/or the genes underlying eating disorders have not yet been analyzed. However, some studies that also used subphenotypes (e.g., restricting type of AN) led to more specific results; however, confirmation is as yet mostly lacking. Systematic genome-wide linkage scans based on families with at least two individuals with an eating disorder (AN or BN) revealed initial linkage regions on chromosomes 1, 3 and 4 (AN) and 10p (BN). Analyses on candidate genes in the chromosome 1 linkage region led to the (as yet unconfirmed) identification of certain variants associated with AN. Genome-wide association studies are under way and will presumably help to identify genes and pathways involved in these eating disorders. The elucidation of the molecular mechanisms underlying eating disorders might improve therapeutic approaches.
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32
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Root T, Pinheiro AP, Thornton L, Strober M, Fernandez-Aranda F, Brandt H, Crawford S, Fichter MM, Halmi KA, Johnson C, Kaplan AS, Klump KL, La Via M, Mitchell J, Woodside DB, Rotondo A, Berrettini WH, Kaye WH, Bulik CM. Substance use disorders in women with anorexia nervosa. Int J Eat Disord 2010; 43:14-21. [PMID: 19260043 PMCID: PMC2807480 DOI: 10.1002/eat.20670] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We examined prevalence of substance use disorders (SUD) in women with: (1) anorexia nervosa (AN) restricting type (RAN); (2) AN with purging only (PAN); (3) AN with binge eating only (BAN); and (4) lifetime AN and bulimia nervosa (ANBN). Secondary analyses examined SUD related to lifetime purging behavior and lifetime binge eating. METHOD Participants (N = 731) were drawn from the International Price Foundation Genetic Studies. RESULTS The prevalence of SUD differed across AN subtypes, with more in the ANBN group reporting SUD than those in the RAN and PAN groups. Individuals who purged were more likely to report substance use than those who did not purge. Prevalence of SUD differed across lifetime binge eating status. DISCUSSION SUD are common in AN and are associated with bulimic symptomatology. Results underscore the heterogeneity in AN, highlighting the importance of screening for SUD across AN subtypes.
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Affiliation(s)
- Tammy Root
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Laura Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Michael Strober
- Semel Institute for Neuroscience and Human Behavior, and Resnick Neuropsychiatric Hospital, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, Feixa Llarga s/n, PC: 08907 Barcelona, Spain, Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III,, Hospital Clínico Santiago de Compostela, Choupana s/n, PC: 15706 Santiago de Compostela, Spain
| | - Harry Brandt
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Steve Crawford
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Manfred M. Fichter
- Department of Psychiatry, University of Munich (LMU), Munich, Germany and Roseneck Hospital for Behavioral Medicine, Prien, Germany
| | - Katherine A. Halmi
- New York Presbyterian Hospital-Westchester Division, Weill Medical College of Cornell University, White Plains, NY
| | | | - Allan S. Kaplan
- Department of Psychiatry, The Toronto Hospital, Toronto, Canada
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, East Lansing, MI
| | - Maria La Via
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - James Mitchell
- Department of Psychiatry, Neuropsychiatric Research Institute, Fargo, ND
| | | | | | - Wade H. Berrettini
- Department of Psychiatry, University of Pennsylvania, School of Medicine, Philadelphia, PA
| | - Walter H. Kaye
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Hinney A, Scherag S, Hebebrand J. Genetic findings in anorexia and bulimia nervosa. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2010; 94:241-70. [PMID: 21036328 DOI: 10.1016/b978-0-12-375003-7.00009-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Anorexia nervosa (AN) and bulimia nervosa (BN) are complex disorders associated with disordered eating behavior. Heritability estimates derived from twin and family studies are high, so that substantial genetic influences on the etiology can be assumed for both. As the monoaminergic neurotransmitter systems are involved in eating disorders (EDs), candidate gene studies have centered on related genes; additionally, genes relevant for body weight regulation have been considered as candidates. Unfortunately, this approach has yielded very few positive results; confirmed associations or findings substantiated in meta-analyses are scant. None of these associations can be considered unequivocally validated. Systematic genome-wide approaches have been performed to identify genes with no a priori evidence for their relevance in EDs. Family-based scans revealed linkage peaks in single chromosomal regions for AN and BN. Analyses of candidate genes in one of these regions led to the identification of genetic variants associated with AN. Currently, an international consortium is conducting a genome-wide association study for AN, which will hopefully lead to the identification of the first genome-wide significant markers.
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Affiliation(s)
- Anke Hinney
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Germany
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34
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de Krom M, Bauer F, Collier D, Adan RAH, la Fleur SE. Genetic variation and effects on human eating behavior. Annu Rev Nutr 2009; 29:283-304. [PMID: 19400703 DOI: 10.1146/annurev-nutr-080508-141124] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Feeding is a physiological process, influenced by genetic factors and the environment. In recent years, many studies have been performed to unravel the involvement of genetics in both eating behavior and its pathological forms: eating disorders and obesity. In this review, we provide a condensed introduction on the neurological aspects of eating and we describe the current status of research into the genetics of eating behavior, primarily focused on specific traits such as taste, satiation, and hunger. This is followed by an overview on the genetic studies done to unravel the heritable background of obesity and eating disorders. We examine the discussion currently taking place in the field of genetics of complex disorders and phenotypes on how to perform good and powerful studies, with the use of large-scale whole-genome association studies as one of the possible solutions. In the final part of this review, we give our view on the latest developments, including endophenotype approaches and animal studies. Studies of endophenotypes of eating behavior may help to identify core traits that are genetically influenced. Such studies would yield important knowledge on the underlying biological scaffold on which diagnostic criteria for eating disorders could be based and would provide information to influence eating behavior toward healthier living.
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Affiliation(s)
- Mariken de Krom
- Rudolf Magnus Institute of Neuroscience, Department of Neuroscience & Pharmacology, UMC Utrecht, Utrecht, The Netherlands.
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35
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Santonastaso P, Bosello R, Schiavone P, Tenconi E, Degortes D, Favaro A. Typical and atypical restrictive anorexia nervosa: weight history, body image, psychiatric symptoms, and response to outpatient treatment. Int J Eat Disord 2009; 42:464-70. [PMID: 19424978 DOI: 10.1002/eat.20706] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Few studies have examined the characteristics of atypical restrictive anorexia nervosa (AN) with a well-powered design. The study aims to explore this issue, with particular attention paid to psychopathology and response to outpatient treatment. METHOD The sample consists of 365 participants with restrictive AN and 204 with atypical AN. Three types of atypical AN were included: subthreshold (all the criteria except weight); partial (AN without amenorrhea); and participants with AN without fear of gaining weight. RESULTS Participants with AN without fear of weight gain reported the lowest lifetime BMI and subthreshold AN the highest. Participant with partial AN reported the highest levels of psychiatric symptoms and novelty seeking. All types of atypical AN showed high rates of dropout, whereas participants with subthreshold AN showed the highest level of full remission after treatment. DISCUSSION Before considering a revision of the diagnostic criteria of AN, further studies on adequately large samples are needed.
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36
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Kim YR, Woo JM, Heo SY, Kim JH, Lim SJ, Yu BH. An Association Study of the A218C Polymorphism of the Tryptophan Hydroxylase 1 Gene with Eating Disorders in a Korean Population: A Pilot Study. Psychiatry Investig 2009; 6:44-9. [PMID: 20046373 PMCID: PMC2796036 DOI: 10.4306/pi.2009.6.1.44] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Revised: 01/30/2009] [Accepted: 02/01/2009] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE We examined the association between the tryptophan hydroxylase 1 (TPH1) gene and eating disorders focusing on obsessionality. METHODS The sample included 62 women with a lifetime diagnosis of anorexia nervosa (AN) as well as 50 women with a lifetime diagnosis of bulimia nervosa (BN) recruited from specialist clinics for eating disorders and 131 healthy women in Korea. Blood samples were collected from all participants for the TPH1 genotyping. The patients were ad ministered the Korean version of the Eating Disorders Examination and obsessionality was conceptualized using measures of persistence, harm avoidance, and obsessive-compulsive symptoms. RESULTS In the case-control comparisons, the frequency of the A/A genotype was increased in the patients with BN, but this difference was not significant after correcting for multiple testing. We found no effect of the TPH A218C polymorphism on obsessionality in the patients with AN or BN. CONCLUSION Although the present findings should be regarded as preliminary because of the small size of our sample, they suggest that the TPH1 gene may contribute to the genetic susceptibility to BN and be associated with the other unexplored traits of bulimic case status.
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Affiliation(s)
- Youl-Ri Kim
- Eating Disorders Clinic, Department of Psychiatry, Seoul Paik Hospital, Inje University School of Medicine, Seoul, Korea
- Stress Research Institute, Inje University, Seoul, Korea
| | - Jong-Min Woo
- Eating Disorders Clinic, Department of Psychiatry, Seoul Paik Hospital, Inje University School of Medicine, Seoul, Korea
- Stress Research Institute, Inje University, Seoul, Korea
| | | | - Jeong Hyun Kim
- Indang Institute of Molecular Biology, Inje University, Seoul, Korea
| | - Soo-Jin Lim
- Eating Disorders Clinic, Department of Psychiatry, Seoul Paik Hospital, Inje University School of Medicine, Seoul, Korea
- Stress Research Institute, Inje University, Seoul, Korea
| | - Bum-Hee Yu
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Jacobs MJ, Roesch S, Wonderlich SA, Crosby R, Thornton L, Wilfley DE, Berrettini WH, Brandt H, Crawford S, Fichter MM, Halmi KA, Johnson C, Kaplan AS, Lavia M, Mitchell JE, Rotondo A, Strober M, Woodside DB, Kaye WH, Bulik CM. Anorexia nervosa trios: behavioral profiles of individuals with anorexia nervosa and their parents. Psychol Med 2009; 39:451-461. [PMID: 18578898 PMCID: PMC3714180 DOI: 10.1017/s0033291708003826] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Anorexia nervosa (AN) is associated with behavioral traits that predate the onset of AN and persist after recovery. We identified patterns of behavioral traits in AN trios (proband plus two biological parents). METHOD A total of 433 complete trios were collected in the Price Foundation Genetic Study of AN using standardized instruments for eating disorder (ED) symptoms, anxiety, perfectionism, and temperament. We used latent profile analysis and ANOVA to identify and validate patterns of behavioral traits. RESULTS We distinguished three classes with medium to large effect sizes by mothers' and probands' drive for thinness, body dissatisfaction, perfectionism, neuroticism, trait anxiety, and harm avoidance. Fathers did not differ significantly across classes. Classes were distinguished by degree of symptomatology rather than qualitative differences. Class 1 (approximately 33%) comprised low symptom probands and mothers with scores in the healthy range. Class 2 ( approximately 43%) included probands with marked elevations in drive for thinness, body dissatisfaction, neuroticism, trait anxiety, and harm avoidance and mothers with mild anxious/perfectionistic traits. Class 3 (approximately 24%) included probands and mothers with elevations on ED and anxious/perfectionistic traits. Mother-daughter symptom severity was related in classes 1 and 3 only. Trio profiles did not differ significantly by proband clinical status or subtype. CONCLUSIONS A key finding is the importance of mother and daughter traits in the identification of temperament and personality patterns in families affected by AN. Mother-daughter pairs with severe ED and anxious/perfectionistic traits may represent a more homogeneous and familial variant of AN that could be of value in genetic studies.
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Affiliation(s)
- M J Jacobs
- University of California, San Diego (UCSD) Eating Disorders Treatment and Research Center, La Jolla, CA, USA.
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Low perception of control as a cognitive factor of eating disorders. Its independent effects on measures of eating disorders and its interactive effects with perfectionism and self-esteem. J Behav Ther Exp Psychiatry 2008; 39:467-88. [PMID: 18328461 DOI: 10.1016/j.jbtep.2007.11.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Revised: 11/05/2007] [Accepted: 11/16/2007] [Indexed: 11/23/2022]
Abstract
OBJECTIVE There is a large body of research about perfectionism and low self-esteem in eating disorders (ED). However, little is known about the influence in ED of a distorted cognition in the domain of control: the perception of low control. The present study examined the main and interactive effects of concern over mistakes (an important dimension of perfectionism), self-esteem, and perception of control on drive for thinness, bulimia, and body dissatisfaction. METHOD Forty individuals with ED and 55 controls completed the Multidimensional Perfectionism Scale, the Anxiety Control Questionnaire, the Rosenberg self-esteem scale, and the three symptomatic scales of the Eating Disorder Inventory, which are drive for thinness, bulimia and body dissatisfaction. Multiple linear regression was used to test the hypothesis that perception of low control has a significant effect on the symptomatic scales of the EDI. RESULTS The ED group had significantly lower perception of control and self-esteem and higher concern over mistakes, drive for thinness, bulimia, and body dissatisfaction than the control group. Analysis of interactive effects suggested that a combination of a low perception of control and a low self-esteem seems to moderate the effects of concern over mistakes on drive for thinness, bulimia, and body dissatisfaction. DISCUSSION ED are associated with a tendency to worry about mistakes, a low sense of self-esteem, and a low perception of control over internal feelings and external events. Perception of control and self-esteem seems to moderate the predictive power of concern mistakes on symptoms of ED. The results suggest that a low perception of control is an important cognitive factor in ED.
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39
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Southgate L, Tchanturia K, Collier D, Treasure J. The development of the childhood retrospective perfectionism questionnaire (CHIRP) in an eating disorder sample. EUROPEAN EATING DISORDERS REVIEW 2008; 16:451-62. [DOI: 10.1002/erv.870] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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40
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Lo Russo L, Campisi G, Di Fede O, Di Liberto C, Panzarella V, Lo Muzio L. Oral manifestations of eating disorders: a critical review. Oral Dis 2008; 14:479-84. [DOI: 10.1111/j.1601-0825.2007.01422.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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41
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Kaye WH, Bulik CM, Plotnicov K, Thornton L, Devlin B, Fichter MM, Treasure J, Kaplan A, Woodside DB, Johnson CL, Halmi K, Brandt HA, Crawford S, Mitchell JE, Strober M, Berrettini W, Jones I. The genetics of anorexia nervosa collaborative study: methods and sample description. Int J Eat Disord 2008; 41:289-300. [PMID: 18236451 PMCID: PMC3755506 DOI: 10.1002/eat.20509] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Supported by National Institute of Mental Health (NIMH), this 12-site international collaboration seeks to identify genetic variants that affect risk for anorexia nervosa (AN). METHOD Four hundred families will be ascertained with two or more individuals affected with AN. The assessment battery produces a rich set of phenotypes comprising eating disorder diagnoses and psychological and personality features known to be associated with vulnerability to eating disorders. RESULTS We report attributes of the first 200 families, comprising 200 probands and 232 affected relatives. CONCLUSION These results provide context for the genotyping of the first 200 families by the Center for Inherited Disease Research. We will analyze our first 200 families for linkage, complete recruitment of roughly 400 families, and then perform final linkage analyses on the complete cohort. DNA, genotypes, and phenotypes will form a national eating disorder repository maintained by NIMH and available to qualified investigators.
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Affiliation(s)
- Walter H. Kaye
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Katherine Plotnicov
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Laura Thornton
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Bernie Devlin
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Manfred M. Fichter
- Department of Psychiatry, University of Munich (LMU), Munich, Germany
- Roseneck Hospital for Behavioral Medicine, Prien, Germany
| | - Janet Treasure
- Department of Academic Psychiatry, Kings College London, Institute of Psychiatry, London, United Kingdom
| | - Allan Kaplan
- Department of Psychiatry, Toronto General Hospital, Toronto, Ontario, Canada
| | - D. Blake Woodside
- Department of Psychiatry, Toronto General Hospital, Toronto, Ontario, Canada
| | | | - Katherine Halmi
- Department of Psychiatry, Weill Cornell Medical College, White Plains, New York
| | - Harry A. Brandt
- Department of Psychiatry, Sheppard Pratt Health System, Towson, Maryland
| | - Steve Crawford
- Department of Psychiatry, Sheppard Pratt Health System, Towson, Maryland
| | - James E. Mitchell
- Department of Psychiatry, Neuropsychiatric Research Institute, Fargo, North Dakota
| | - Michael Strober
- Department of Psychiatry, Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, California
| | - Wade Berrettini
- Department of Psychiatry, Center of Neurobiology and Behavior, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ian Jones
- Department of Psychological Medicine, University of Birmingham, England
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42
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Von Holle A, Pinheiro AP, Thornton LM, Klump KL, Berrettini WH, Brandt H, Crawford S, Crow S, Fichter MM, Halmi KA, Johnson C, Kaplan AS, Keel P, La Via M, Mitchell J, Strober M, Woodside DB, Kaye WH, Bulik CM. Temporal patterns of recovery across eating disorder subtypes. Aust N Z J Psychiatry 2008; 42:108-17. [PMID: 18197505 DOI: 10.1080/00048670701787610] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To compare patterns of recovery in individuals with index episodes of anorexia nervosa (AN) and bulimia nervosa (BN). METHOD Using Kaplan-Meier methods and Cox proportional hazards models, comparisons were conducted that were conditional on duration of eating disorder from onset and included a conservative recovery criterion of 3 asymptomatic years. Data collection was retrospective and from two of the international Price Foundation genetic studies on 901 individuals with eating disorders. RESULTS Using Kaplan-Meier methods, 11% of those with index AN and 10% of those with index BN met recovery criteria at 10 years. At 15 years, 16% of those with index AN and 25% of those with index BN met recovery criteria. In a Cox proportional hazards model the index BN group had three times the rate of recovery at 10-14 years (p=0.01) than the index AN group. CONCLUSIONS Initially the probability of recovery was greater for those with index AN, but as the duration of the eating disorder lengthened those with BN had higher probabilities of recovery. Replication of these results with prospective data using similarly stringent recovery criteria and methods is required to confirm trends.
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Affiliation(s)
- Ann Von Holle
- Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina 27599-7160, USA
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43
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Reba-Harrelson L, Von Holle A, Thornton LM, Klump KL, Berrettini WH, Brandt H, Crawford S, Crow S, Fichter MM, Goldman D, Halmi KA, Johnson C, Kaplan AS, Keel P, LaVia M, Mitchell J, Plotnicov K, Rotondo A, Strober M, Treasure J, Woodside DB, Kaye WH, Bulik CM. Features associated with diet pill use in individuals with eating disorders. Eat Behav 2008; 9:73-81. [PMID: 18167325 PMCID: PMC2248697 DOI: 10.1016/j.eatbeh.2007.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Revised: 03/07/2007] [Accepted: 04/25/2007] [Indexed: 11/25/2022]
Abstract
We investigated the relation between diet pill use and eating disorder subtype, purging and other compensatory behaviors, body mass index (BMI), tobacco and caffeine use, alcohol abuse or dependence, personality characteristics, and Axis I and Axis II disorders in 1,345 participants from the multisite Price Foundation Genetics Studies. Diet pill use was significantly less common in women with restricting type of AN than in women with other eating disorder subtypes. In addition, diet pill use was associated with the use of multiple weight control behaviors, higher BMI, higher novelty seeking, and the presence of anxiety disorders, alcohol abuse or dependence, and borderline personality disorder. Findings suggest that certain clinical and personality variables distinguish individuals with eating disorders who use diet pills from those who do not. In the eating disorder population, vigilant screening for diet pill use should be routine clinical practice.
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Affiliation(s)
| | - Ann Von Holle
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC
| | - Laura M. Thornton
- Department of Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute & Clinic, Pittsburgh, PA
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, East Lansing, MI
| | - Wade H. Berrettini
- Center of Neurobiology and Behavior, University of Pennsylvania, Philadelphia, PA
| | - Harry Brandt
- Center for Eating Disorders, Sheppard Pratt Health System, Towson, MD
| | - Steven Crawford
- Center for Eating Disorders, Sheppard Pratt Health System, Towson, MD
| | - Scott Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Manfred M. Fichter
- Klinik Roseneck, Hospital for Behavioral Medicine and University of Munich (LMU), Germany
| | - David Goldman
- National Institute of Alcohol Abuse and Alcoholism, Rockville, MD
| | - Katherine A. Halmi
- Weill Cornell Medical College, New York Presbyterian Hospital - Westchester Division, White Plains, NY
| | | | - Allan S. Kaplan
- Program for Eating Disorders, Toronto General Hospital, University Health Network, University of Toronto, Canada
| | - Pamela Keel
- Department of Psychology, University of Iowa
| | - Maria LaVia
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC
| | - James Mitchell
- University of North Dakota School of Medicine and Health Sciences, Department of Clinical Neuroscience and Neuropsychiatric Research Institute, Fargo, ND
| | - Katherine Plotnicov
- Department of Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute & Clinic, Pittsburgh, PA
| | - Alessandro Rotondo
- Department of Psychiatry, Pharmacology and Biotechnologies, University of Pisa, Pisa, Italy
| | - Michael Strober
- UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Janet Treasure
- Department of Psychiatry, Institute of Psychiatry, King's College, London, England
| | | | - Walter H. Kaye
- Department of Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute & Clinic, Pittsburgh, PA
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC,Department of Nutrition, University of North Carolina, Chapel Hill, NC
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Ramoz N, Versini A, Gorwood P. Eating disorders: an overview of treatment responses and the potential impact of vulnerability genes and endophenotypes. Expert Opin Pharmacother 2007; 8:2029-44. [PMID: 17714058 DOI: 10.1517/14656566.8.13.2029] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Anorexia nervosa (AN), bulimia nervosa (BN) and binge-eating disorder (BED) are the three main eating disorders. Antidepressants, antipsychotics, anticonvulsants, prokinetic agents, opiate antagonists, appetite suppressants, tetrahydrocannabinol, cyproheptadine, zinc and ondansetron have been tested, and are frequently associated with psychological treatment. Selective serotonin reuptake inhibitors have a proven efficacy in BN and binge eating disorder. Other treatments, such as atypical antipsychotics in AN, anticonvulsants in BN and BED, and naltrexone and ondansetron in BN, may be promising, but lack the appropriate trials. The development of genetic researches in eating disorders may help the clinician to choose the most appropriate treatment in forthcoming years, using genetic polymorphisms of vulnerability genes, those linked to endophenotypes, or genes implicated in the metabolism of the drug treatment.
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Affiliation(s)
- Nicolas Ramoz
- 1INSERM U675, Université Paris 7, IFR02, Faculté de Médecine Xavier Bichat, Paris, France
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45
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Poyastro Pinheiro A, Thornton LM, Plotonicov KH, Tozzi F, Klump KL, Berrettini WH, Brandt H, Crawford S, Crow S, Fichter MM, Goldman D, Halmi KA, Johnson C, Kaplan AS, Keel P, LaVia M, Mitchell J, Rotondo A, Strober M, Treasure J, Woodside DB, Von Holle A, Hamer R, Kaye WH, Bulik CM. Patterns of menstrual disturbance in eating disorders. Int J Eat Disord 2007; 40:424-34. [PMID: 17497704 DOI: 10.1002/eat.20388] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To describe menstrual disturbance in eating disorders (ED). METHOD We describe menstrual history in 1,705 women and compare eating, weight, and psychopathological traits across menstrual groups. RESULTS Menstrual dysfunction occurred across all eating disorder subtypes. Individuals with normal menstrual history and primary amenorrhea reported the highest and lowest lifetime body mass index (BMI), respectively. Normal menstruation and oligomenorrhea groups reported greater binge eating, vomiting, and appetite suppressant use. Amenorrhea was associated with lower caloric intake and higher exercise. Harm avoidance, novelty seeking, perfectionism, and obsessionality discriminated among menstrual status groups. No differences in comorbid Axis I and II disorders were observed. CONCLUSION Menstrual dysfunction is not limited to any eating disorder subtype. BMI, caloric intake, and exercise were strongly associated with menstrual function. Menstrual status is not associated with comorbidity. Menstrual irregularity is an associated feature of all ED rather than being restricted to AN only.
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Affiliation(s)
- Andréa Poyastro Pinheiro
- Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina 27599-7160, USA
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46
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Brown KMO, Bujac SR, Mann ET, Campbell DA, Stubbins MJ, Blundell JE. Further evidence of association of OPRD1 & HTR1D polymorphisms with susceptibility to anorexia nervosa. Biol Psychiatry 2007; 61:367-73. [PMID: 16806108 DOI: 10.1016/j.biopsych.2006.04.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2006] [Revised: 04/05/2006] [Accepted: 04/05/2006] [Indexed: 11/17/2022]
Abstract
BACKGROUND A recent study reported strong evidence for the involvement of a region on human chromosome 1 and genetic susceptibility to anorexia nervosa (AN). A more detailed analysis of this region has suggested 2 genes that may account for this susceptibility. These data suggest that polymorphisms in both the serotonin 1D (HTR1D) and opioid delta 1 (OPRD1) receptor genes show a significant association with restricting AN (RAN). METHODS In the current study, we have conducted an independent association study on 226 females meeting DSM-IV criteria for AN and 678 matched volunteers. RESULTS We genotyped 4 SNPs in HTR1D and 6 SNPs in OPRD1. 3 SNPs were found to be associated with both RAN and binge-purge AN (BPAN) within the gene for OPRD1. We also found evidence of association between 2 polymorphisms within HTR1D and RAN. CONCLUSIONS These data support the hypothesis that polymorphisms within this region form a component of the genetic basis to susceptibility to RAN. However, further work is required to understand the processes that may be mediated by these genes.
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Affiliation(s)
- Kirsty M O Brown
- University of Dundee, Department of Public Health, Dundee, United Kingdom.
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47
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Forbush K, Heatherton TF, Keel PK. Relationships between perfectionism and specific disordered eating behaviors. Int J Eat Disord 2007; 40:37-41. [PMID: 16958125 DOI: 10.1002/eat.20310] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Perfectionism has been reported as a specific risk factor for anorexia nervosa and bulimia nervosa, but not binge eating disorder. This study examined whether these differences are due to differential associations between perfectionism and specific eating disorder behaviors. METHOD Participants (N = 2,482) completed the eating disorders inventory perfectionism scale and a questionnaire assessing eating disorder symptoms. RESULTS Perfectionism was associated with an array of disordered eating behaviors in women. However, associations were strongest for fasting and purging. Further, the association between binge eating and perfectionism was statistically mediated by fasting. In men, perfectionism was significantly associated only with fasting, and this association was greater than associations with other disordered eating behaviors. CONCLUSION Results explain why previous studies have reported weak or inconsistent associations between perfectionism and binge eating and may inform etiological models of EDNOS characterized by fasting or purging.
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Affiliation(s)
- Kelsie Forbush
- Department of Psychology, The University of Iowa, Iowa City, Iowa, USA.
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48
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Santonastaso P, Zanetti T, De Antoni C, Tenconi E, Favaro A. Anorexia nervosa patients with a prior history of bulimia nervosa. Compr Psychiatry 2006; 47:519-22. [PMID: 17067877 DOI: 10.1016/j.comppsych.2006.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2005] [Revised: 12/20/2005] [Accepted: 02/09/2006] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES To investigate clinical and psychological features of patients with anorexia nervosa (AN) with a previous history of bulimia nervosa. METHOD Three hundred thirty-three patients with a full diagnosis of AN were assessed by the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the Eating Disorders Inventory, and the Hopkins Symptom Checklist. RESULTS Twenty-four patients (7%) reported a previous diagnosis of bulimia nervosa and were compared with a control group of 48 patients without a history of bulimia, matched for diagnostic subtype. Among the patients with a history of bulimia nervosa, 11 were of the restricting type and 13 of the binge eating/purging type. Among restricting anorexic patients, those with a history of bulimia reported greater age of onset, more psychiatric symptoms, more family psychiatric morbidity, and a higher rate of sexual abuse. On the contrary, among patients with the AN bingeing-purging subtype, the presence of a previous bulimia nervosa was not associated with any of the investigated variables. CONCLUSIONS Patients with restricting AN who report a history of previous bulimia nervosa are not frequent among those referring to an outpatient eating disorders unit. However, our findings in this small group of subjects confirm that a lifetime history of bingeing and purging in patients with eating disorder, irrespective of when it occurs, is always associated with more psychopathology compared with those restricting patients with AN who have never had a period of bingeing and purging.
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Affiliation(s)
- Paolo Santonastaso
- Clinica Psichiatrica, Dipartimento di Neuroscienze, Università di Padova, 35128 Padova, Italy
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49
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Anzengruber D, Klump KL, Thornton L, Brandt H, Crawford S, Fichter MM, Halmi KA, Johnson C, Kaplan AS, LaVia M, Mitchell J, Strober M, Woodside DB, Rotondo A, Berrettini WH, Kaye WH, Bulik CM. Smoking in eating disorders. Eat Behav 2006; 7:291-9. [PMID: 17056404 DOI: 10.1016/j.eatbeh.2006.06.005] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2005] [Revised: 05/30/2006] [Accepted: 06/02/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Smoking has been reported as an appetite and weight control method in eating disorders; however, few studies have explored patterns of smoking across subtypes of eating disorders. The aim of this paper was to explore the patterns and prevalence of smoking behavior in 1,524 women from two of the multisite Price Foundation Genetic studies. METHOD Smoking behavior was assessed in 306 individuals with anorexia nervosa-restricting type (RAN), 186 with anorexia nervosa-purging type (PAN), 180 with anorexia nervosa and bulimia nervosa (ANBN), 107 with anorexia nervosa-binging type (BAN), 71 individuals with purging type-bulimia nervosa (PBN), and 674 female community controls. We compared smoking prevalence and smoking behaviors across eating disorder (ED) subtypes and in comparison to controls using the Fagerstrom Test of Nicotine Dependence (FTND). RESULTS Overall, women with eating disorders reported higher rates of smoking and greater nicotine dependence than controls. Women with binge/purge subtypes of eating disorders reported the highest rates of smoking of all of the subtypes. Smoking in eating disorders was related to impulsive personality traits. CONCLUSIONS Women with eating disorders appear to be at increased risk for smoking, particularly those who binge eat and/or purge and display impulsive personality characteristics. Given the high prevalence, the impact of ongoing smoking on maintenance of eating disorders symptoms is worthy of both clinical and research attention.
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Affiliation(s)
- Doris Anzengruber
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7160, USA
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50
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Ringham R, Klump K, Kaye W, Stone D, Libman S, Stowe S, Marcus M. Eating disorder symptomatology among ballet dancers. Int J Eat Disord 2006; 39:503-8. [PMID: 16715486 DOI: 10.1002/eat.20299] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The current study sought to compare eating disorder symptomatology among ballet dancers and individuals with restricting anorexia nervosa (RAN), bulimia nervosa (BN), and no eating pathology. METHOD Twenty-nine female ballet dancers completed assessments and were compared with an archival dataset of 26 women with RAN, 47 women with BN, and 44 women with no eating pathology. Eating disorder diagnoses and behaviors were assessed with a semi-structured clinical interview, the Eating Disorder Inventory (EDI), and a weight history interview. RESULTS Eighty-three percent of dancers met lifetime criteria for AN (6.9%), BN (10.3%), AN+BN (10.3%), or EDNOS (55.0%). Moreover, dancers looked more similar to eating-disordered individuals than to control individuals on measures of eating pathology. CONCLUSION Despite previous emphasis on the pathology AN, the current findings suggest that dancers frequently engage in binge eating and purging behaviors. Moreover, it appears that their pathology is as severe as that of non-dancing women with eating disorders.
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Affiliation(s)
- Rebecca Ringham
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
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