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T65
EPISTATIC INTERACTION OF 5HTTLPR AND TPH2 POLY-
MORPHISMS PREDICT LEVELS OF NOVELTY SEEKING
IN WOMEN WITH BULIMIA NERVOSA
Lea Thaler
1,2,3
, Patricia Groleau
1,3
, Ghislaine Badawi
1,3
,
Lindsay Sycz
1,3
, Mimi Israel
1,2,3
, Ridha Joober
3
, Kenneth R
Bruce
1,2,3
, Howard Steiger
1,2,3
1
Eating Disorders Program, Douglas University Institute, Mon-
treal, QC, Canada,
2
Psychiatry Department, McGill University,
Montreal, QC, Canada,
3
Research Centre, Douglas University
Institute, Montreal, QC, Canada
The serotonin system is known to influence a variety of func-
tions including eating, mood, personality and temperament,
making the system a good candidate in the study of eating
disorders. Accordingly, genetic polymorphisms acting in the
serotonin system, such as 5HTTLPR and TPH2, are reported
to contribute to specific temperamental and personality mani-
festations in Bulimia Nervosa (BN). For example, in BN, the S
allele of 5HTTLPR and the T allele of TPH2 have been linked
to novelty seeking, impulsivity, and affective instability. The
present study examined whether 5HTTLPR and TPH2 interact
in an epistatic manner to influence psychopathological traits
and eating symptoms in a sample of women with BN-spec-
trum disorders. We had 277 women provide blood for genetic
assays, and measured eating-disorder symptoms and psycho-
pathological traits using structured interviews and self-report
questionnaires. We observed a significant epistatic interaction
on an outcome measure of novelty seeking, such that women
who possessed both the S allele of 5HTTLPR and the T allele
of TPH2 had higher scores than did women with other allelic
combinations. No significant interactions were evinced for eat-
ing symptoms or other psychopathological traits. Our findings
suggest that genes acting in the serotonin system interact to
influence personality psychopathology, and our results add to
the body of literature associating serotonergic polymorphisms
with personality psychopathology in BN.
T66
ONE BROAD CATEGORY OF FEEDING AND EATING DIS-
ORDERS FOR ICD-11
Cornelia Thiels
University of Applied Sciences Bielefeld, Bielefeld, Germany
Purpose:
To create one ED category for all ages which
combines anorexia and bulimia nervosa if criteria for both
disorders are met either concurrently or sequentially.
Method:
Codes using 1-3 digits behind the dot were created
like for
bipolar disorder in ICD-10.
Results:
The first digit behind the
dot codes
present weight or
present and past weight if the
history of a significantly different and worse weight abnormal-
ity than at present is known. The second digit behind the dot
codes present mental and behavioural pathology, the third his-
tory of mental and behavioural pathology. F50.517 codes ED,
at present restrictive AN with significant underweight, history
of avoidant restrictive food intake disorder with avoidance of
foods as a result of preoccupations with perceived aversive
consequences of eating and dangerously low body weight.
Conclusion:
Especially if done in a computerized way it
should be easy to code EDs using a developmental approach.
T67
APP FOR MAKING EATING DISORDER DIAGNOSES
Cornelia Thiels
University of Applied Sciences Bielefeld, Bielefeld, Germany
Purpose: To provide sufferers of ED and (professional) carers
but also people with weight and eating problems of less
severity with a questionnaire which can also be used as a
semi-structured interview or simply as a tool to create the
ICD-11 ED codes proposed in a companion paper. Method:
This paper was developed as a part of discussions related
to the World Health Organization’s revision of the ICD-10,
although the ideas presented here do not represent official
proposals. The questions follow the numbers of the three
digits behind the dot, starting with weight and continuing with
present and past mental and behavioral pathology. Simple
language is used for maximum accessibility. Results: The
resulting software with branching and skipping can be used
e. g. in the waiting room, on any personal computer or mobile
phone. To encourage completing the questionnaire weight re-
sults (BMI, percentiles for youngsters and weight categories)
are given early on. Although the questions have been written
to fit ICD-11 they could be altered slightly to give a fuller histo-
ry of the ED and allow the calculation of time frames proposed
for DSM 5. If this software is used repeatedly by the same
person, it results in a prospective documentation of the ED.
Conclusion: This software can be used for diagnostic purpos-
es, but equally for training (e.g. by encouraging history taking)
and research, all at low cost.
T68
A Comparison of Personality Characteristics, Psychiatric
Comorbidity and Stressful Life Events in Monozygotic
Twins Discordant for Anorexia Nervosa
Sara E Trace
1
, Laura M Thornton
1
, Suzanne E Mazzeo
2
,
Jocilyn E Bergin
3
, Millie Maxwell
1
, Paul Lichtenstein
4
, Nancy L
Pedersen
4,5
, Cynthia M Bulik
1,6
1
Department of Psychiatry, University of North Carolina, Chap-
el Hill, NC, USA,
2
Department of Psychology, Virginia Com-
monwealth University, Richmond, VA, USA,
3
Virginia Institute
for Psychiatric and Behavioral Genetics, Virginia Common-
wealth University, Richmond, VA, USA,
4
Department of
Medical Epidemiology and Biostatistics, Karolinska Institutet,
Stockholm , Sweden,
5
Department of Psychology, University
of Souther California, Los Angeles, CA, USA,
6
Department of
Nutrition, University of North Carolina, Chapel Hill, NC, USA
Introduction.
Anorexia nervosa (AN) is moderately heritable
and environmental factors also contribute substantially to its
etiology. Yet, specific environmental factors that may increase
liability to AN have not been clearly identified. We evaluated
personality, comorbidity, and environmental factors that may
contribute to the onset of AN. Since monozygotic (MZ) twins
are genetically identical, differences between them reflect
primarily environmental factors.
Method.
Participants included
22 MZ twin pairs discordant for AN from the Swedish Twin
study of Adults: Genes and Environment. Using cotwin control
methodology, affected and unaffected twins were compared
on demographics, personality and temperament character-
istics, psychiatric comorbidity, and stressful life events using
McNemar’s tests or paired t-tests.
Results.
Affected twins
had significantly lower BMIs at the time of the interview (p
<.002) and younger age at first diet than unaffected cotwins
(p <.034). In addition, affected twins had higher scores on the
perfectionism dimensions of concern over mistakes (p <.018),
doubts about actions (p <.002), and personal standards (p
<.001) than unaffected cotwins. However, significantly more
unaffected cotwins reported emotional neglect at some point
during their lifetime compared to affected twins (p <.032).
Conclusions.
Early dieting and high levels of perfection-
ism may be salient in the development of AN. Results may
indicate a previously undocumented negative impact of AN on
unaffected cotwins.
T69
INCIDENCE AND 5-YEAR OUTCOME OF EATING DISOR-
DERS IN AN EPIDEMIOLOGICAL CATCHMENT AREA IN
THE NETHERLANDS
Daphne van Hoeken
1
, Hans W Hoek
1,2,3
1
Parnassia Bavo Psychiatric Institute, The Hague, Nether-
lands,
2
Columbia University, New York, NY, USA,
3
Groningen
University, Groningen, Netherlands
Introduction: The Hague is a large (over 500.000 inhabitants
Jan 1 2012) city in The Netherlands. The Parnassia Bavo
Institute is the main provider of mental health care to adults
in the region. It has an electronic case register containing a
wealth of information on all patients, including demographic
characteristics, diagnoses and treatment contacts. Due to the
almost complete coverage of mental health care facilities, the
case register is an important source of psychiatric epidemi-
ological information on the catchment area of The Hague.
We aim to provide treated incidence rates at the population
level of The Hague, with 5-year follow-up data on diagnostic
POSTER SESSION 1 ABSTRACTS