On the role of dopamine in the pathophysiology of anorexia nervosa

Barry, Virginia; Klawans, Harold L.

doi:10.1007/bf01262969

Cited by 127 publications

(39 citation statements)

References 54 publications

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“…21 It has also been hypothesized that amenorrhea is related to neurotransmitter abnormalities such as increased dopamine activity. 22,23 Therefore, it is possible that important biological differences exist between individuals with AN who are menstruating compared with those who are not. If the presence of amenorrhea reflects biological differences central to understanding the etiology of the illness and/or developing treatments, then it may be a useful diagnostic criterion.…”

Section: Potential Biological Differences Signified By Amenorrheamentioning

confidence: 99%

Should amenorrhea be a diagnostic criterion for anorexia nervosa?

Attia

Roberto

2009

Intl J Eating Disorders

145

102

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Objective: The removal of the amenorrhea criterion for anorexia nervosa (AN) is being considered for the fifth edition of The Diagnostic and Statistical Manual (DSM-V). This article presents and discusses the arguments for maintaining as well as those for removing the criterion. Method:The psychological and biological literatures on the utility of amenorrhea as a distinguishing diagnostic criterion for AN and as an indicator of illness severity are reviewed.Results: The findings suggest that the majority of differences among patients with AN who do and do not meet the amenorrhea criterion appear largely to reflect nutritional status. Overall, the two groups have few psychological differences. There are mixed findings regarding biological differences between those with AN who do and do not menstruate and the relationship between amenorrhea and bone health among patients with AN.Discussion: Based on these findings, one option is to describe amenorrhea in DSM-V as a frequent occurrence among individuals with AN that may provide important information about clinical severity, but should not be maintained as a core diagnostic feature. The possibilities of retaining the criterion or eliminating it altogether are discussed.

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Section: Potential Biological Differences Signified By Amenorrheamentioning

confidence: 99%

Should amenorrhea be a diagnostic criterion for anorexia nervosa?

Attia

Roberto

2009

Intl J Eating Disorders

145

102

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“…1 Family and twin studies indicate a significant genetic contribution 2,3 and pharmacological data suggest possible dysfunction of the serotonergic 4,5 and dopaminergic [6][7][8][9] pathways. Catechol-O-methyltransferase (COMT) is a candidate gene for mediating susceptibility to AN since it is involved in the dopamine catabolism 10 and because its functional polymorphism (Val/Met 158) determines high (H) and low (L) enzymatic activity alleles.…”

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confidence: 99%

Association of anorexia nervosa with the high activity allele of the COMT gene: a family-based study in Israeli patients

et al. 2001

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Keywords: eating disorders; catechol-O-methyltransferase (COMT); polymorphism; haplotype relative risk (HRR); transmission disequilibrium test (TDT)Anorexia nervosa (AN) is a common, severe and disabling psychiatric disorder, characterized by profound weight loss and body image disturbance. 1 Family and twin studies indicate a significant genetic contribution 2,3 and pharmacological data suggest possible dysfunction of the serotonergic 4,5 and dopaminergic 6-9 pathways. Catechol-O-methyltransferase (COMT) is a candidate gene for mediating susceptibility to AN since it is involved in the dopamine catabolism 10 and because its functional polymorphism (Val/Met 158) determines high (H) and low (L) enzymatic activity alleles. 11 Fifty-one Israeli AN patients and their parents were genotyped with the COMT polymorphism. Using the haplotype relative risk (HRR) method it was found that the frequency of the H allele among alleles transmitted to AN patients from their parents was significantly higher than in those not transmitted (68% vs 51% 2 = 5.20, df = 1, P = 0.023, odds ratio: 2.01). Transmission disequilibrium test (TDT) revealed that out of 49 heterozygote parents the H allele was transmitted to AN patients 33 times while the L allele was transmitted only 16 (McNemar's 2 = 5.90, df = 1, P = 0.015). Our study suggests that the COMT gene is associated with genetic susceptibility to AN, and that individuals homozygous for the high activity allele (HH) have a two-fold increased risk for development of the disorder. Molecular Psychiatry (2001) 6, 243-245.Fifty-one DSM-IV anorexia nervosa female patients and both their parents were genotyped for the COMT gene (valine to methionine at codon 158) polymorphism. In the light of inherent problems facing association studies, we used the haplotype relative risk (HRR) 12 and the transmission disequilibrium test (TDT) 13 methods that are robust to artifacts caused by population stratification. The genotypes in each family were examined and analyzed so as to determine which of the parents' alleles were transmitted to the affected daughters. The non-transmitted alleles were used to construct the nontransmitted genotypes. According to the HRR method, genotypes and alleles in the patient population are compared with the non-transmitted alleles and genotypes that form the optimal ethnically matched control population. The distribution of the transmitted and non-transmitted genotypes and alleles in the fifty-one trios is presented in Table 1.Homozygotes for the high activity allele (HH) were significantly more frequent among AN patients than in the non-transmitted controls (51% vs 29%, 2 = 4.01, df = 1, P = 0.043; odds ratio: 2.50, 95% CI 1.10-5.64). When allelic distribution was compared, it was found that the high activity allele is significantly more common among patients than in the non-transmitted alleles (68% vs 51%, 2 = 5.20, df = 1, P = 0.023, odds ratio: 2.01, 95% CI 1.39-3.55). The parent population did not differ from the 172 healthy Israeli controls in terms of genotypic and...

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“…Furthermore, Barry and Klawans [2] showed a correlation between loss of appe tite, reduction of weight, hyperactivity, body image distortion and higher receptor activity in specific dopaminergic neuronal systems. The authors did not consider this dopamin ergic feedback control defect as a result of anorexia nervosa but as its origin.…”

Section: Neurobiological Aspectsmentioning

confidence: 99%

“…At the end of their paper their statement seems to be a now already historic but false analogical con clusion: 'If a physiologic dysfunction is re sponsible for anorexia nervosa, it is clear that the name 'anorexia nervosa' is obsolete, as the name assumes a purely psychologic origin of the disease. Perhaps it is time to update the name' [2], Even though these results exemplify neurobiological modifications of drive-related behaviour, it is obvious that long-standing motivated and intensive behaviour can in duce functional changes of substrate [37], These neurobiological alterations perpetuate themselves as secondary behaviour modifi cations without a psychological structure of reference. Neurobiological mechanisms of addictive behaviour can be arranged in the same context.…”

Section: Neurobiological Aspectsmentioning

confidence: 99%

Syndrome Metamorphoses in Anorexia nervosa – An Example of Integrative Psychopathology

Böning

Kachel²

1990

Psychopathology

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In connection with the current knowledge of interdisciplinary results of research, we discuss clinical syndrome transitions of psychotic and non-psychotic quality in the course of anorexia nervosa. According to its internal and external conditions, anorexia nervosa can in principle occur in any person and in any phase of life during a critical trial situation as an ontologically given possibility of specific psychosomatic reaction. In the course of a mainly neurobiologically determined protopathic change of psychologically initiated cross-sectional psychopathology, very heterogenous secondary syndromes (impulsive, phobic, obsessive-compulsive, addictive, autoaggressive, depressive and schizophreniform) may facultatively become manifest. The similarity of such anorexia nervosa metamorphoses with classical nosological disease entities is likely to be based on a common disturbance of biological feedback systems. As a touchstone of classical ‘intermediate area’ in psychiatry the changing clinical picture of anorexia nervosa provokes a unitarian view of mental disease. It exemplifies a hesitant change of paradigm in an up till now dualistic conception of organic/biological and psychological models. This complementary approach tries to integrate psychic phenomena into a holistic understanding of complex psychopathological realities on the basis of qualitative and dimensional aspects in order to counteract the nowadays threatening loss of information in psychiatric phenomenology.

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On the role of dopamine in the pathophysiology of anorexia nervosa

Cited by 127 publications

References 54 publications

Should amenorrhea be a diagnostic criterion for anorexia nervosa?

Should amenorrhea be a diagnostic criterion for anorexia nervosa?

Association of anorexia nervosa with the high activity allele of the COMT gene: a family-based study in Israeli patients

Syndrome Metamorphoses in Anorexia nervosa – An Example of Integrative Psychopathology

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