32
EDRS 2013
T40
Candidate Genes in Relation to Major Depressive Disorder (MDD)
Trajectories Across Time: Improved Replication with a Refined
Phenotype Based on Chronic Course?
Xiaochen Luo
1
,
Nikolaos Stavrakakis
1
,
Brenda W. Penninx
1,2,3
,
Peter de
Jonge
1
,
Fokko J. Bosker
1
,
Willem A. Nolen
1
,
Jan H. Smit
3,4
,
Eco J. de
Geus
4
,
Dorret I. Boomsma
4
,
Gonneke Willemsen
4
,
Harold Snieder
5
,
Ilja M.
Nolte
5
,
Catharina A. Hartman
1
1
Department of Psychiatry, University Medical Center Groningen,
Groningen, Netherlands,
2
Department of Psychiatry, Leiden University
Medical Center, Leiden, Netherlands,
3
Department of Psychiatry, VU
University Medical Center Amsterdam, Amsterdam, Netherlands,
4
Department of Biological Psychology, VU University Amsterdam,
Amsterdam, Netherlands,
5
Unit of Genetic Epidemiology and
Bioinformatics, Department of Epidemiology, University Medical Center
Groningen, Groningen, Netherlands
Introduction:
Similar to studies of eating disorders, few candidate
genes for MDD have been replicated. Phenotypic diversity and genetic
heterogeneity are some of the most likely reasons. This study aimed to
narrow phenotypic and genetic heterogeneity by examining candidate
genes for chronic and severe MDD. Given high comorbidity between
eating disorders and MDD, this study could inform genetic studies of
eating disorders as well.
Methods:
All MDD case-control association
studies from 9/2007 to 6/2012 were reviewed to identify candidate genes
for analysis. We then conducted latent class growth analysis (LCGA) to
select chronic cases from a sample of 1,352 cases of MDD drawn from
national databases in the Netherlands. Finally, we conducted case-control
comparisons between healthy controls (n=1,649), the full MDD sample,
and the chronic cases.
Results:
Approximately 52% of studies found
associations between MDD and 227 polymorphisms in 94 candidate
genes. Using LCGA, 225 chronic MDD cases were identified. Case-
control comparisons are on-going and should be completed by 9/2013.
Conclusions:
Association studies of MDD have produced inconsistent
results, likely due to inadequate phenotyping and genetic heterogeneity.
Our focus on a chronic MDD sample may yield more consistent findings
and may inform genetic studies of eating disorders, particularly given
recent emphasis on cross-diagnostic conceptualizations of etiology (e.g.,
NIMH RDoC initiative).
T41
Subthreshold Eating Disorders in Middle-Aged Women
Barbara Mangweth-Matzek
1
,
Hans W. Hoek
2
,
Claudia I. Rupp
3
,
Kerstin
Lackner-Seifert
4
,
Nadja Frey
1
,
Alexandra B. Whitworth
5
,
Harrison G.
Pope
6
,
Johann Kinzl
1
1
Department of Psychosomatic Medicine, Innsbruck, Austria,
2
Parnassia
Psychiatric Institute, The Hague, Netherlands,
3
Department of Psychiatry
and Psychotherapy, Innsbruck, Austria,
4
Department of Psychoogy,
Innsbruck, Austria,
5
Paracelsus Medical University, Salzburg, Austria,
6
Biological Psychiatry Laboratory, Boston, MA, USA
We assessed eating pathology and associated clinical features in middle-
aged women with subthreshold eating disorders as compared to women
with normal eating and full-syndrome eating disorders. Anonymous
questionnaires were mailed to 1276 Austrian women aged 40-60 years
covering normal eating behavior, subthreshold eating disorders, eating
disorders (as defined by DSM-IV), body image, medical and psychiatric
disorders, and quality of life. “Subthreshold eating disorders” was defined
by the presence of either 1) binge eating with loss of control or 2)
purging behavior, without requiring any of the other usual DSM-IV criteria
for frequency or severity of these symptoms. We obtained evaluable
responses from 715 (56%) women. Thirty-three (4.6%) reported symptoms
meeting full DSM-IV criteria for an eating disorder. Thirty-four (4.8%)
displayed subthreshold eating disorders. The women in this latter group
reported levels of associated psychopathology virtually equal to women
with full-syndrome diagnoses, and significantly greater than women
with normal eating, on a broad range of psychopathological and clinical
measures. We found prominent pathology even in women reporting simply
binge eating or purging behavior in the absence of any requirement for
frequency or severity. Thus even broadly defined subthreshold eating
disorders, may be associated with distress and impairment approaching
that seen with full-scale eating disorders in this population.
T42
Factors Influencing Recruitment and Retention of Adolescents in a
Bed RCT
Suzanne E. Mazzeo
1
,
Janet A. Lydecker
1
,
Rachel W. Gow
1
,
Allison A.
Palmberg
1
,
Marilyn Stern
1
,
Marian Tanofsky-Kraff
2
,
Cynthia M. Bulik
3
1
Virginia Commonwealth University, Richmond, VA, USA,
2
Uniformed
Services University of the Health Sciences, Bethesda, MD, USA,
3
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Recruitment and retention of adolescents in clinical trials for eating
disorders treatment is challenging. This paper describes recruitment
methods and predictors of retention in an RCT for adolescents with
binge eating (BE). Participants were recruited from community programs,
provider referrals, and direct mail. Following phone screening, participants
were scheduled for baseline assessments then randomized to one of two
manualized treatments for BE. Recruitment yielded 152 calls from families
interested in a BE program. Participants came from direct mail (52.6%),
provider referrals (15.1%) and community programs (16.2%). Mothers
(82.2%)
typically made the initial contact; some adolescents called on
their own (10.5%). Parents represented diverse backgrounds: 52.2%
(
n
= 71) identified as African American and 37.5% (
n
= 51) identified as
White. Attrition was high in both groups; of those who attended at least
half of the sessions, 37.9% (
n
= 11) identified as African American and
51.7% (
n
= 15) identified as White. Cognitive complexity (
r
= .453,
p
=
.034)
and self-acceptance (
r
= -.580,
p
= .004) predicted the percentage
of sessions adolescents attended. Results confirm the difficulty in
recruitment and retention of adolescents with BE. Problem identification,
cognitive development and other personal factors appeared to play a role
in treatment enrollment and attrition. Utilization of these results for future
iterations of these manualized treatments will be discussed.
T43
Understanding Internalization of Weight Bias Among Obese Women
Janell L. Mensinger
1
,
David George
2
,
Krista L. Rompolski
1
,
Deanne Zotter
3
1
Drexel University, Philadelphia, PA, USA,
2
Reading Health System,
Reading, PA, USA,
3
West Chester University, West Chester, PA, USA
Introduction:
Primum non nocere has received recent attention given
the escalation of possibly iatrogenic public health efforts towards the
“
eradication” of obesity. Research has shown that obese individuals
receive biased medical treatment by healthcare providers. Coping
with prevailing beliefs about personal responsibility for one’s size has
significant consequences, particularly for obese people who have
internalized weight stigmatization. This study aims to identify associations
between weight bias internalization, psychological variables, disordered
eating behaviors, food & weight concerns.
Method:
The sample consisted
of 67 women (mean age 40; mean BMI 39; 96% white) who took part in a
randomized controlled trial comparing the health benefits of two lifestyle
interventions. All variables considered were measured at baseline using
validated and reliable scales.
Results:
Weight bias internalization was
related to EDEQ total scores, TFEQ uncontrolled & emotional eating,
depression, hedonic hunger, self-esteem, & quality of life (r=.46; r=.32;
r=.35, r=.26, r=.35; r=-.53; r=-.39; respectively, p’s <.05). There was no
relationship with anxiety, stress, cognitive restraint, or dietary habits.
Conclusion:
The internalization of weight bias is an important factor
in psychological health as well as pathogenic eating, food, and weight
concerns in obese women. We must educate healthcare providers about
the potential effect of implicit negative attitudes towards obese patients.
T44
Outcomes of Anorexia Nervosa in the Community - 10 Year Follow-up
Linda Mustelin
1
,
Anu Raevuori
1
,
Aila Rissanen
2
,
Jaakko Kaprio
1
,
Anna
Keski-Rahkonen
1
1
Department of Public Health, University of Helsinki, Helsinki, Finland,
2
Department of Psychiatry, Helsinki University Central Hospital, Helsinki,
Finland
Background:
Few studies have assessed the long-term
sociodemographic and health-related outcomes of anorexia nervosa
(
AN) in the general population.
Methods:
We followed women suffering
from DSM-IV AN identified from the population-based FinnTwin16 cohort
(
born 1975-1979) for 10 years after the baseline diagnostic interview
(
N=55, follow-up participation rate 73%, mean age at follow-up 34 years).
Results:
None of the women with AN had died and 88% were weight-
recovered (BMI≥18.5 kg/m
2
).
The weights of women of AN ranged from
17.1
to 29.8 kg/m
2
;
their mean BMI (22.0 kg/m
2
)
still significantly differed
from controls (24.0 kg/m
2
,
p=0.007). Women with lifetime AN did not
significantly differ from controls in terms of university education (38%
vs. 29%, p=0.25) or unemployment (5% vs. 4%, p=0.82). We observed
trends toward a lower likelihood of marrying/cohabiting (68% vs. 78%,
p=0.12) and having children (50% vs. 65%, p=0.05) among women with
AN, driven by women who had been in recovery for <10 years. There
were slight but statistically nonsignificant differences between women with
AN and controls in the General Health Questionnaire (p=0.10) and self-
reported psychosomatic symptoms (p=0.25).
Conclusions
:
The long-term
prognosis of anorexia nervosa is more favorable than previously thought:
weight-restoration and psychological recovery is very common, but we
observed some residual symptoms and a lower likelihood of marrying/
cohabiting and having children.
T45
Group Differences, Time Trends, and Effect of Autism Spectrum
Disorders on Outcome in Teenage-Onset Anorexia Nervosa
Evaluated by the Morgan-Russell Outcome Assessment Schedule: A
Controlled Community-Based Study
Soren Nielsen
1
,
Henrik Anckarsater
2
,
Carina Gillberg
3
,
Christopher
Gillberg
3,4,5
,
Maria Rastam
6
,
Elisabet Wentz
3
1
Child Psychiatric Clinic, Næstved, Denmark,
2
Institute of Neuroscience
and Physiology, Forensic Psychiatry, Gothenburg, Sweden,
3
Gillberg
Neuropsychuatry Centre, Gothenburg, Sweden,
4
Department of Child
and Adolescent Psychiatry, Strathclyde University, Glasgow, Scotland,
POSTER SESSION 1 ABSTRACTS
