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Wade TD, Gordon S, Medland S, Bulik CM, Heath AC, Montgomery GW, Martin NG. Genetic variants associated with disordered eating. Int J Eat Disord 2013; 46:594-608. [PMID: 23568457 PMCID: PMC3775874 DOI: 10.1002/eat.22133] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2013] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Although the genetic contribution to the development of anorexia nervosa (AN) has long been recognized, there has been little progress relative to other psychiatric disorders in identifying specific susceptibility genes. Here, we have carried out a genome-wide association study on an unselected community sample of female twins surveyed for eating disorders. METHOD We conducted genome-wide association analyses in 2,564 female twins for four different phenotypes derived from self-report data relating to lifetime presence of 15 types of disordered eating: AN spectrum, bulimia nervosa (BN) spectrum, purging via substances, and a binary measure of no disordered eating behaviors versus three or more. To complement the variant level results, we also conducted gene-based association tests using VEGAS software. RESULTS Although no variants reached genome-wide significance at the level of p < 10(-8), six regions were suggestive (p < 5 × 10(-7)). The current results implicate the following genes: CLEC5A, LOC136242, TSHZ1, and SYTL5 for the AN spectrum phenotype; NT5C1B for the BN spectrum phenotype; and ATP8A2 for the disordered eating behaviors phenotype. DISCUSSION As with other medical and psychiatric phenotypes, much larger samples and meta-analyses will ultimately be needed to identify genes and pathways contributing to predisposition to eating disorders.
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Affiliation(s)
- Tracey D Wade
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
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Berg KC, Peterson CB, Frazier P, Crow SJ. Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. Int J Eat Disord 2012; 45:428-38. [PMID: 21744375 PMCID: PMC3668855 DOI: 10.1002/eat.20931] [Citation(s) in RCA: 707] [Impact Index Per Article: 58.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2011] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The purpose of this study was to systematically review the reliability of scores on the Eating Disorder Examination (EDE) and the Eating Disorder Examination-Questionnaire (EDE-Q) and to examine the validity of their use as measures of eating disorder symptoms. METHOD Articles describing the psychometric properties of the EDE and EDE-Q were identified in a systematic search of major computer databases and a review of reference lists. Articles were selected based on a priori inclusion and exclusion criteria. RESULTS Fifteen studies were identified that examined the psychometrics of the EDE, whereas 10 studies were found that examined the psychometrics of the EDE-Q. DISCUSSION Both instruments demonstrated reliability of scores. There is evidence that scores on the EDE and EDE-Q correlate with scores on measures of similar constructs and support for using the instruments to distinguish between cases and non-cases. Additional research is needed to broaden the generalizability of the findings.
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Affiliation(s)
- Kelly C Berg
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA.
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Wade TD, Treloar SA, Heath AC, Martin NG. An examination of the overlap between genetic and environmental risk factors for intentional weight loss and overeating. Int J Eat Disord 2009; 42:492-7. [PMID: 19235851 PMCID: PMC2753484 DOI: 10.1002/eat.20668] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To further our understanding of how intentional weight loss (IWL) and overeating are related, we examined the shared genetic and environmental variance between lifetime IWL and overeating. METHOD Interview data were available for 1,976 female twins (both members of 439 and 264 pairs of monozygotic and dizygotic twins, respectively), mean age = 40.61, SD = 4.72. We used lifetime diagnostic data for eating disorders obtained from a semistructured psychiatric telephone interview, examined in a bivariate twin analysis. Both lifetime behaviors were measured on a 3-point scale, where absence of IWL or overeating formed one anchor on the scale and lifetime anorexia nervosa (AN) and bulimia nervosa (BN) formed the opposite anchors, respectively. RESULTS In line with previous findings, a higher body mass index was significantly associated with the lifetime presence of IWL and/or overeating (odds ratio = 1.13, 95% confidence interval (CI): 1.08-1.19). The best fitting twin model contained additive genetic and nonshared environmental influence influencing both IWL and overeating, with correlations between these influences of 0.61 (95% CI: 0.35-0.92) and 0.24 (95% CI: 0.07-0.42), respectively. DISCUSSION About 37% of genetic risk factors were considered to overlap between IWL and overeating, and with only 6% of overlap between environmental risk factors. Thus, considerable independence of risk factors was indicated.
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Affiliation(s)
- Tracey D. Wade
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Susan A. Treloar
- Queensland Institute of Medical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Andrew C. Heath
- Missouri Alcoholism Research Centre, Department of Psychiatry, Washington University School of Medicine, USA
| | - Nicholas G Martin
- Queensland Institute of Medical Research, University of Queensland, Brisbane, Queensland, Australia
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Wildes JE, Marcus MD, Fagiolini A. Prevalence and correlates of eating disorder co-morbidity in patients with bipolar disorder. Psychiatry Res 2008; 161:51-8. [PMID: 18782643 PMCID: PMC2643248 DOI: 10.1016/j.psychres.2007.09.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2007] [Revised: 06/22/2007] [Accepted: 09/14/2007] [Indexed: 11/19/2022]
Abstract
This study was designed to document eating disorder symptoms in a well-defined sample of patients with bipolar disorder and to evaluate the relationship of current loss of control over eating (LOC) to demographic and clinical features hypothesized to characterize bipolar patients at risk for disordered eating. Eighty-one patients enrolled in the Bipolar Disorder Center for Pennsylvanians provided demographic information and completed the Structured Clinical Interview for DSM-IV Axis I Disorders. The Eating Disorder Examination was administered by independent clinicians to evaluate current and lifetime eating disorder symptomatology. Twenty-one percent of participants met DSM-IV criteria for a lifetime eating disorder, and 44% reported a history of LOC. Patients who endorsed weekly LOC during the past six months (n=18) were heavier, had more atypical depressive symptoms, and were more likely to have a lifetime substance use disorder compared to patients in the rest of the sample (n=63). These findings indicate that eating disorder symptoms are prevalent in patients with bipolar disorder and are associated with obesity and other psychiatric morbidity. Screening for eating disorders in bipolar patients is warranted, as intervention may minimize distress and improve treatment outcome.
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Affiliation(s)
- Jennifer E Wildes
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
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de Man Lapidoth J, Ghaderi A, Halvarsson-Edlund K, Norring C. Psychometric properties of the Eating Disorders in Obesity questionnaire: validating against the Eating Disorder Examination interview. Eat Weight Disord 2007; 12:168-75. [PMID: 18227638 DOI: 10.1007/bf03327594] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Inconclusive results of how weight-loss treatment (WLT) results are affected by participants' eating disorders and/or binge eating are partly due to the variation caused by the multitude of assessment instruments used. The objective of the present study was to evaluate the psychometric properties of a short DSM-IV-based assessment instrument designed to be used specifically in WLT settings, the Eating Disorders in Obesity (EDO) questionnaire. Participants were 97 patients seeking WLT at four surgical and one non-surgical clinics. Participants were assessed by the EDO and the Eating Disorder Examination (EDE) interview . The validity and reliability of the EDO was measured as concordance with the EDE, and test-retest agreement of the EDO, respectively. Validity as well as reliability was found to be good for both eating disorders diagnoses and binge eating as a distinct symptom. Results suggest that the EDO is a short, easily administered instrument with good psychometric properties which makes it a suitable, economical method of assessing eating disorders and binge eating in clinical WLT settings.
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Affiliation(s)
- J de Man Lapidoth
- Department of Clinical Medicine, Orebro University, and Psychiatric Research Centre, SE-70116 Orebro, Sweden.
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Bosanac P, Kurlender S, Stojanovska L, Hallam K, Norman T, McGrath C, Burrows G, Wesnes K, Manktelow T, Olver J. Neuropsychological study of underweight and "weight-recovered" anorexia nervosa compared with bulimia nervosa and normal controls. Int J Eat Disord 2007; 40:613-21. [PMID: 17607697 DOI: 10.1002/eat.20412] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To compare executive, memory and visuospatial functioning of DSM-IV anorexia nervosa (AN), bulimia nervosa (BN), and normal controls (NC). METHOD A comparison of women involving: (i) 16 AN with body mass indices (BMI) < or = 17.5 kg/m(2); (ii) 12 AN with BMI > 18.5 kg/m(2) for at least 3 months; (iii) 13 BN; and (iv) 16 NC participants was performed with groups of similar age and intelligence. Groups were assessed with EDE-12, MADRS, HAMA, Cognitive Drug Research (CDR) battery, and Bechara tasks. RESULTS Significant impairments in CDR Power of Attention were present in underweight AN and BN participants. CDR Morse Tapping was significantly impaired in all clinical groups. The BN and weight-recovered AN groups were significantly impaired on CDR immediate word recall. The BN group alone was significantly impaired on CDR delayed word recall. CONCLUSION Attentional impairment is similar in AN and BN. Impaired motor tasks in AN persist after "weight-recovery" and are similar to impairments in BN. BN may be discriminated from AN on word recall.
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Affiliation(s)
- Peter Bosanac
- Department of Psychiatry, University of Melbourne, Austin Hospital, Studley Road, Heidelberg 3084, Melbourne, Australia.
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Bosanac P, Kurlender S, Norman T, Hallam K, Wesnes K, Manktelow T, Burrows G. An open-label study of quetiapine in anorexia nervosa. Hum Psychopharmacol 2007; 22:223-30. [PMID: 17487935 DOI: 10.1002/hup.845] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Atypical antipsychotics may be beneficial in treating the core psychopathology of anorexia nervosa (AN). METHODS An 8 week open-label study of quetiapine was conducted in eight severely ill DSM-IV AN patients consecutively admitted to a specialist eating disorders unit. Participants were assessed by EDE-12, MADRS, YBOCS, SAPS-delusions and CDR neuropsychological battery at baseline, 4 weeks and 8 weeks, and by weekly body mass index (BMI), CGI and extrapyramidal scores. Quetiapine doses ranged from 50 mg to 800 mg per day, according to efficacy and tolerability. RESULTS Seven participants completed 4 weeks and five participants completed 8 weeks. All participants had clinically significant levels of specific eating disorders psychopathology, and mild to moderately severe depressive symptomatology. Apart from initial mild sedation, no subjects experienced any significant adverse events. Over 4 weeks there was no significant difference in BMI, but a significant difference in the EDE-12 restraint score. There were significant differences on BMI and EDE-12 restraint subscale scores over 8 weeks. CONCLUSIONS A double-blind placebo controlled study is required to further evaluate the therapeutic utility of quetiapine in severely ill AN patients beyond multidisciplinary specialist intervention.
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Affiliation(s)
- P Bosanac
- Department of Psychiatry, University of Melbourne, and Austin Hospital, Australia.
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Jacobs-Pilipski MJ, Wilfley DE, Crow SJ, Walsh BT, Lilenfeld LRR, West DS, Berkowitz RI, Hudson JI, Fairburn CG. Placebo response in binge eating disorder. Int J Eat Disord 2007; 40:204-11. [PMID: 17103417 PMCID: PMC2798075 DOI: 10.1002/eat.20287] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Placebo response in studies of binge eating disorder (BED) has raised concern about its diagnostic stability. The aims of this study were (1) to compare placebo responders (PRs) with nonresponders (NRs); (2) to investigate the course of BED following placebo response; and (3) to examine attributions regarding placebo response. METHOD The baseline placebo run-in phase (BL) was part of a RCT investigating sibutramine hydrochloride for BED; it included 451 participants, ages 19-63, diagnosed with BED. Follow-up (FU) included 33 PRs. RESULTS : In this study, 32.6% of participants responded to placebo (PRs = 147; NRs = 304). PRs exhibited significantly less symptom severity. At FU (n = 33), many PRs reported continued symptoms. CONCLUSION PRs exhibited significantly less severe pathology than NRs. Placebo response in BED may transitory or incomplete. The results of this study suggest variable stability in the BED diagnosis.
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Affiliation(s)
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of MedicineSt. Louis, Missouri
- *Correspondence to: Weight Management and Eating Disorders Program, Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, Campus Box 8134, St. Louis, MO 63110. E-mail:
| | - Scott J Crow
- Department of Psychiatry, University of MinnesotaMinneapolis, Minnesota
| | - B Timothy Walsh
- New York State Psychiatric Institute, Columbia-Presbyterian Medical CenterNew York, New York
| | | | - Delia Smith West
- Department of Health Behavior, College of Public Health, University of Arkansas for Medical SciencesFayetteville, Arkansas
| | - Robert I Berkowitz
- Department of Psychiatry, Weight and Eating Disorders Program, University of Pennsylvania School of Medicine, Philadelphia and Department of Child and Adolescent Psychiatry, The Children's Hospital of PhiladelphiaPhiladelphia, Pennsylvania
| | - James I Hudson
- Department of Psychiatry, Harvard Medical School and McLean HospitalBelmont, Massachusetts
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Rieger E, Wilfley DE, Stein RI, Marino V, Crow SJ. A comparison of quality of life in obese individuals with and without binge eating disorder. Int J Eat Disord 2005; 37:234-40. [PMID: 15822089 DOI: 10.1002/eat.20101] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study investigates whether binge eating disorder (BED) in obese individuals is associated with a greater degree of impairment in quality of life (QOL) than obesity alone. METHOD Treatment-seeking obese individuals with and without BED were compared on QOL scores using the Impact of Weight on Quality of Life (IWQOL-Lite) questionnaire. RESULTS With the exception of the Physical Function subscale, obese individuals with BED scored significantly higher than non-BED participants on each of the subscales and on the total scale of the IWQOL-Lite. For all participants, body mass index (BMI) was related significantly to scores on the Physical Function and Public Distress subscales of the IWQOL-Lite. DISCUSSION Obese individuals with BED have impaired functioning on psychosocial aspects of QOL in addition to poorer physical functioning associated with obesity. These findings underscore the pervasive impact of BED in obese individuals, as BED is associated with more impairment than obesity alone.
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Hilbert A, Tuschen-Caffier B, Ohms M. Eating Disorder Examination: Deutschsprachige Version des strukturierten Essstörungsinterviews. DIAGNOSTICA 2004. [DOI: 10.1026/0012-1924.50.2.98] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Das Eating Disorder Examination (EDE) von Fairburn und Cooper (1993) ist ein strukturiertes Essstörungsinterview zur Erfassung der spezifischen Psychopathologie von Essstörungen. In der klinischen Forschung und Praxis gilt es weithin als Methode der Wahl für die Essstörungsdiagnostik. Die in diesem Beitrag vorgestellte deutschsprachige, reübersetzte Version des EDE zeigte in Stichproben von 80 Patientinnen mit Bulimia Nervosa, 144 Patientinnen mit Binge-Eating-Störung und 20 Patientinnen mit Anorexia Nervosa hohe Interrater-Reliabilitäten der Items sowie der Subskalen. Als Indikatoren für die konvergente Validität waren die EDE-Subskalen Shape Concern und Weight Concern mit Selbstbeurteilungsskalen zum Körperbild, z.B. dem Fragebogen zum Figurbewusstsein, hoch korreliert. Die EDE-Subskalen Restraint und Eating Concern zeigten signifikante Zusammenhänge mit dem in Ernährungstagebüchern protokollierten Essverhalten, z.B. Mahlzeiten- oder Essanfallshäufigkeit oder Nährstoffaufnahme. Die Subskalen des EDE unterschieden zwischen Gruppen mit verschiedenen Essstörungsdiagnosen und bildeten Veränderungen durch psychologische Psychotherapie sensitiv ab. Somit steht mit der deutschsprachigen Version des EDE ein dem englischsprachigen Original entsprechendes, geeignetes Instrument für die Erfassung der spezifischen Psychopathologie von Essstörungen zur Verfügung.
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Wade TD, Bulik CM, Kendler KS. Reliability of lifetime history of bulimia nervosa. Comparison with major depression. Br J Psychiatry 2000; 177:72-6. [PMID: 10945092 DOI: 10.1192/bjp.177.1.72] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Previous studies have found that the reliability of the lifetime prevalence of bulimia nervosa is low to moderate. However, the reasons for poor reliability remain unknown. AIMS We investigated the ability of a range of variables to predict reliability, sensitivity, and specificity of reporting of both bulimia nervosa and major depression. METHOD Two interviews, approximately 5 years apart, were completed with 2163 women from the Virginia Twin Registry. RESULTS After accounting for different base rates, bulimia nervosa was shown to be as reliably reported as major depression. Consistent with previous studies of major depression, improved reliability of bulimia nervosa reporting is associated with more severe bulimic symptomatology. CONCLUSIONS Frequent binge eating and the presence of salient behavioural markers such as vomiting and laxative misuse are associated with more reliable reporting of bulimia nervosa. In the absence of the use of fuller forms of assessment, brief interviews should utilise more than one prompt question, thus increasing the probability that memory of past disorders will be more successfully activated and accessed.
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Affiliation(s)
- T D Wade
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0126, USA
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Abstract
OBJECTIVE Twin methodology has been used to delineate etiological factors in many medical disorders and behavioral traits including eating disorders. Although twin studies are powerful tools, their methodology can be arcane and their implications easily misinterpreted. METHOD The goals of this study are to (a) review the theoretical rationale for twin studies; (b) provide a framework for their interpretation and evaluation; (c) review extant twin studies on eating disorders; and (d) explore the implications for understanding etiological issues in eating disorders. DISCUSSION On the basis of this review, it is not possible to draw firm conclusions regarding the precise contribution of genetic and environmental factors to anorexia nervosa. Twin studies confirm that bulimia nervosa is familial and reveal significant contributions of additive genetic effects and of unique environmental factors in liability to bulimia nervosa. The magnitude of the contribution of shared environment is less clear, but in the studies with the greatest statistical power, it appears to be less prominent than additive genetic factors.
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Affiliation(s)
- C M Bulik
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Medical College of Virginia of Virginia Commonwealth University, Richmond, VA 23298-0126, USA.
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