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40
A meal was offered from which they were allowed to eat ad
libitum. Subjects rated hunger, thirst and anxiety throughout
the experiment.
Results
: Both AN groups showed altered
associations between appetite hormones and brain respons-
es to food. They also reported decreased hunger prior to the
meal. Despite decreased hunger, HC and r-AN ate similar
amounts. No differences were found in thirst. Anxiety was
highest in c-AN and with the highest anxiety reported after
the meal.
Conclusions:
Despite long-term weight recovery,
r-AN react to food stimuli with lower subjective hunger and
aberrant brain activity patterns while ghrelin concentrations
remain high. This suggests that eating behavior continues to
be impaired after recovery from AN.
T61
ATTENTION NETWORK DYSFUNTION IN BULIMIA NER-
VOSA – AN FMRI STUDY
Jochen M Seitz, Manuel Hueck, Brigitte Dahmen, Eva Kno-
spe, Beate Herpertz-Dahlmann, Kerstin Konrad
Child and Adolescent Psychiatry Unit, University Hospital,
RWTH Aachen, Aachen, Germany
Introduction: Patients with Bulimia Nervosa (BN) have
been shown to be more impulsive and less attentive than
healthy controls (HC). Also, there seems to be an increased
comorbidity with ADHD (odds ratio 3.6). However, little is
known about the neural correlates of this impulsiveness and
inattention and its importance for the pathophysiology of
BN. Methods: 55 patients with BN and 40 HC aged between
15 and 36 years (mean 23 years) were investigated with
diagnostic questionnaires regarding ADHD (SBB, WRI,
WURS-K) and the Barret Impulsivity Scale (BIS). A computer
based neuropsychological test battery for attention, work-
ing memory and impulsivity (TAP) was applied. 15 of these
patients and 20 HC additionally took part in an fMRI paradigm
to test different subsystems of attention (modified attention
network task, mANT). Results: Patients with BN showed a
greater rate of comorbid ADHD and were more impulsive than
HC in questionnaires. The neuropsychological investigation
confirmed attention deficits and more impulsive responses.
First fMRI results showed predominantly network dysfunction
in the executive control system. Conclusions: Impulsivity
and inattention seem to play an important role in the patho-
physiology of BN. Different neural activation pattern seem to
point towards altered functional networks for attention. The
complete results of the fMRI experiment and their implications
will be presented.
T62
EATING DISORDER PSYCHOPATHOLOGY AND ITS
IMPACT ON THE NUTRITIONAL INTAKE OF COMMUNITY
WOMEN
Anita M Star
1
, Amanda Savvaidis
2
, Phillipa J Hay
1,3
, Jonathan
Mond
4
1
James Cook University, Townsville, Australia,
2
Charles Sturt
University, Wagga Wagga, Australia,
3
Unversity of Western
Sydney, Sydney, Australia,
4
Newcastle University, Orange,
Australia
Purpose:
To examine the relationship between eating disor-
der symptoms and nutrition in community women.
Methods:
A cross sectional nutritional intake survey was embedded into
a larger longitudinal survey of women’s eating disorder symp-
toms. Nutritional adequacy was determined by reference
to Australian Recommended Daily Intakes. Seventy-seven
symptomatic women were compared to 253 control women
recruited form tertiary institutions.
Results:
The nutritional
intake of all women appeared to be low in many key nutrients.
There were no significant differences in the daily nutritional
intake of symptomatic and non symptomatic women. Howev-
er, women with high dietary restraint had significantly lower
daily intakes of energy, carbohydrate, total fat and various
types of fatty acids and fat soluble vitamins and higher dietary
restraint was associated with higher energy intake during
binge eating episodes.
Conclusion:
An association was
found between eating disorder psychopathology and nutrition-
al intake of community dwelling women. Health professionals
should thus focus on targeting weight compensatory be-
haviours for prevention and treatment in both eating disorder
and obesity fields.
T63
OLFACTORY FUNCTION AND ALTERNATION LEARNING
IN EATING DISORDERS
Daniel Stein
1,2
, Ruth Gross-Isseroff
3
, Roni Besserglick
4
, Gad
Mayer
5
, Hillary Voet
6
, Abraham Weizman
2,3
1
Safra Children’s Hospital, Sheba Medical Center, Tel Hasho-
mer, Israel,
2
Sackler Faculty of Medicine, Tel Aviv University,
Tel Aviv, Israel,
3
Geha Mental Health Center, Petah Tikva, Is-
rael,
4
Department of Psychology, Tel Aviv University, Tel Aviv,
Israel,
5
Shalvata Mental Health Center, Hod Hasharon, Israel,
6
Robert H. Smith Faculty of Agriculture, Food and Environ-
ment, Hebrew University of Jerusalem, Rehovot, Israel
Introduction: We sought to assess whether eating disorders
(ED) patients would show orbitofrontal dysfunction, consid-
ered a prominent feature of obsessive compulsive disorder
(OCD). Methods: We studied female adolescent inpatients
with anorexia nervosa restricting type (n=40), anorexia
nervosa binge/purge type (n=23), bulimia nervosa or eating
disorder not otherwise specified-purge type (n=33), and
non-ED control females (n=20). Patients were assessed at
admission and at discharge, when achieving weight resto-
ration and symptom stabilization, for depression, non-ED,
and ED-related OC symptoms. Orbitofrontal functioning was
assessed with an alternation learning task, and with a battery
assessing olfactory threshold and discrimination. Control
females were assessed once. Results: ED patients of all sub-
types performed better than controls on olfactory threshold
and discrimination, but not on alternation learning. Better orbi-
tofrontal functioning was associated with greater ED-related
obsessionality. No changes were found in olfactory threshold
and discrimination between acutely-ill and symptomatical-
ly-stabilized patients. The improvement shown in alternation
learning from admission to discharge was suggested to
reflect a learning effect. Conclusions: The better orbitofrontal
functioning of ED patients in comparison to controls may
represent a core feature of the ED that is independent of
malnutrition and deranged eating behaviors, but is associated
with ED-related obsessionality.
T64
A Conceptual Model for Binge Eating Disorder Based
on a Literature Review, Expert Insight, and Qualitative
Patient Interviews
Dylan Supina
1
, Alan L. Shields
2
, Jonathan Stokes
2
, Fiona
Taylor
2
, Farrah Pompilus
2
, Laure Delbecque
2
, M. Haim Erder
1
1
Shire Pharmaceuticals, Wayne, PA, USA,
2
Adelphi Values,
Boston, MA, USA
Introduction
: Binge eating disorder (BED) is a multi-faceted
condition that includes many symptoms best assessed by the
patient (e.g., loss of eating control). To specify and organize
the domains and concepts that characterize the experience
of BED, a patient-centric conceptual model of the disorder
was developed.
Methods
: Following the US Food and Drug
Administration’s guidance on the development of patient
reported outcomes, the BED conceptual model was informed
by a literature review, BED experts (n=4), and qualitative
interviews with BED patients (n=20).
Results
: The BED con-
ceptual model summarizes and organizes the integrated per-
spectives of patients, experts, and the literature by explicitly
linking condition domains and concepts. A total of 15 physical,
cognitive, and emotional symptoms associated with binge
eating episodes emerged and were reported as important
and bothersome from between 30% and 100% of interviewed
patients. An additional 11 concepts associated with BED (but
not directly related to binge eating episodes) were reported
as important and bothersome from between 40% and 75%
of interviewed patients.
Conclusions
: The BED conceptual
model provides new insights on the importance of both symp-
toms and impacts associated with BED and can inform under-
standing of the disorder generally as well as BED treatment
research more specifically.
POSTER SESSION 1 ABSTRACTS