Skip to main content

Biomarkers and Endophenotypes in Eating Disorders

  • Chapter

Abstract

The aim of this chapter is to discuss the concept of endophenotypes within the eating disorder (ED) population. As is common in most forms of psychiatric illness, people with ED have additional psychological problems, as do their family members. Affective disorders, addictions, and autistic spectrum disorders commonly occur in association with the individual and/or in the families of those with ED. This chapter will explore the literature related to underlying biological markers that potentially underpin all of these disorders. Some of the biomarkers fulfi l the criteria for an endophenotype, although this is an area that is poorly developed so far in the eating disorder fi eld. It is possible that core inherited vulnerability traits such as anxiety, rigidity, weak coherence, poor social cognition, compulsivity and impulsivity are some of the features held in common with other disorders.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Hudson JI, Hiripi E, Pope HG, et al. The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biol Psychiatry 2007; 2007: 348–358

    Article  Google Scholar 

  2. van Hoeken D, Seidell J, Wijbrand H. Epidemiology. In Treasure J, Schmidt U and van Furth E, eds. Handbook of Eating Disorders, 2nd ed. Chichester: Wiley; 2003: 11–34

    Google Scholar 

  3. Fairburn C, Harrison P. Eating disorders. Lancet 2003; 361: 407–416

    Article  PubMed  Google Scholar 

  4. Striegel-Moore R, Bulik C. Risk factors for eating disorders. Am Psychol 2007; 62: 181–198

    Article  PubMed  Google Scholar 

  5. Russell G. Bulimia nervosa: An ominous variant of anorexia nervosa. Psychol Med 1979; 9: 429–448

    Article  PubMed  CAS  Google Scholar 

  6. Anderluh M, Tchanturia K, Rabe-Hesketh S, et al. Childhood obsessive-compulsive personality traits in adult women with eating disorders: Defining a broader eating disorder pheno-type. Am J Psychiatry 2003; 160: 242–247

    Article  PubMed  Google Scholar 

  7. Gillberg IC, Rastam M, Gillberg C. Anorexia nervosa outcome: Six-year controlled longitudinal study of 51 cases including a population cohort. J Am Acad Child Adolesc Psychiatry 1994; 33: 729–739

    Article  PubMed  CAS  Google Scholar 

  8. Harris E, Barraclough B. Excess mortality of mental disorder. Br J Psychiatry 1998; 173: 11–53

    Article  PubMed  CAS  Google Scholar 

  9. Bulik C, Sullivan P, Tozzi F, et al. Prevalence, heritability, and prospective risk factors for anorexia nervosa. Arch Gen Psychiatry 2006; 63: 305–312

    Article  PubMed  Google Scholar 

  10. Ackard D, Fulkerson J, Neumark-Sztainer D. Prevalence and utility of DSM-IV eating disorder diagnostic criteria among youth. Int J Eat Disord 2007; 40: 409–417

    Article  PubMed  Google Scholar 

  11. Herzog W, Deter H, Fiehn W, et al. Medical findings and predictors of long-term physical outcome in anorexia ner-vosa: A prospective, 12-year follow-up study. Psychol Med 1997; 27: 269–279

    Article  PubMed  CAS  Google Scholar 

  12. Fichter M, Quadflieg N. Long-term stability of eating disorder diagnoses. Int J Eat Disord 2007; 40: S61–S66

    Article  PubMed  Google Scholar 

  13. Favaro A, Ferrara S, Santonastaso P. The spectrum of eating disorders in young women: A prevalence study in a general population sample. Psychosom Med 2003; 65: 701–708

    Article  PubMed  Google Scholar 

  14. Garfinkel P, Lin E, Goering P, et al. Bulimia nervosa in a Canadian community sample: Prevalence and comparison of subgroups. Am J Psychiatry 1995; 152: 1052–1058

    PubMed  CAS  Google Scholar 

  15. Lewinsohn P, Striegel-Moore R, Seeley J. Epidemiology and natural course of eating disorders in young women from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry 2000; 39: 1284–1292

    Article  PubMed  CAS  Google Scholar 

  16. Kjelsas E, Bjornstrom C, Gotestam K. Prevalence of eating disorders in female and male adolescents (14–15 years). Eat Behav 2004; 5: 13–25

    Article  PubMed  Google Scholar 

  17. Mond J, Hay P, Rodgers B, et al. Assessing quality of life in eating disorder patients. Qual Life Res 2005; 14: 171–178

    Article  PubMed  CAS  Google Scholar 

  18. Mathers C, Vos E, Stevenson C, et al. The Australian burden of disease study: Measuring the loss of health from diseases, injuries and risk factors. Med J Aust 2000; 172: 592–596

    PubMed  CAS  Google Scholar 

  19. O'Brien K, Vincent N. Psychiatric comorbidity in anorexia and bulimia nervosa: Nature, prevalence, and causal relationships. Clin Psychol Rev 2003; 23: 57–74

    Article  PubMed  Google Scholar 

  20. Hjern A, Lindberg L, Lindblad F. Outcome and prognostic factors for adolescent female in-patients with anorexia ner-vosa: 9- to 14-year follow-up. Br J Psychiatry 2006; 189: 428–432

    Article  PubMed  Google Scholar 

  21. Tiller J, Sloane G, Schmidt U, et al. Social support in patients with anorexia nervosa and bulimia nervosa. Int J Eat Disord 1997; 21: 31–38

    Article  PubMed  CAS  Google Scholar 

  22. Treasure J, Murphy T, Szmukler G, et al. The experience of caregiving for severe mental illness: A comparison between anorexia nervosa and psychosis. Soc Psychiatry Psychiatr Epidemiol 2001; 36: 343–347

    Article  PubMed  CAS  Google Scholar 

  23. Whitney J, Haigh R, Weinman J, et al. Caring for people with eating disorders: Factors associated with psychological distress and negative caregiving appraisals in carers of people with eating disorders. Br J Clin Psychol 2007; 46: 413–428

    Article  PubMed  Google Scholar 

  24. Striegel-Moore R, Leslie D, Petrill S, et al. One-year use and cost of inpatient and outpatient services among female and male patients with an eating disorder: Evidence from a of health insurance claims Int J Eat Disord 2000; 27: 381–389

    Article  PubMed  CAS  Google Scholar 

  25. Byford S, Barrett B, Roberts C, et al. Economic evaluation of a randomised controlled trial for anorexia nervosa in adolescents. Br J Psychiatry 2007; 191: 436–440

    Article  PubMed  Google Scholar 

  26. Striegel-Moore R, DeBar L, Wilson G, et al. Health services use in eating disorders. Psychol Med 2007; 2: 1–10

    Google Scholar 

  27. Collier DA, Treasure J. The aetiology of eating disorders. Br J Psychiatry 2004; Nov: 363–365

    Google Scholar 

  28. Klump K, Bulik C, Kaye W, et al. Eating disorders are serious mental illnesses. Int J Eat Disord 2008 (in press). doi 10.1002/eat.20589

    Google Scholar 

  29. Bulik CM, Hebebrand J, Keski-Rahkonen A, et al. Genetic epidemiology, endophenotypes, and eating disorder classification. Int J Eat Disord 2007; 40: S52–S60

    Article  PubMed  Google Scholar 

  30. Treasure J, Lopez C, Roberts M. Endophenotypes in eating disorders: Moving toward etiologically based diagnosis and treatment focused on pathophysiology. Pediatric Health 2007; 1: 171–181

    Article  Google Scholar 

  31. Treasure J. Getting beneath the phenotype of anorexia ner-vosa: The search for viable endophenotypes and genotypes. Can J Psychiatry 2007; 52: 212–209

    PubMed  Google Scholar 

  32. Steiger H, Bruce KR. Phenotypes, endophenotypes, and genotypes in bulimia spectrum eating disorders. Can J Psychiatry 2007; 52: 220–227

    PubMed  Google Scholar 

  33. Hudson J, Poper H. Genetic epidemiology of eating disorders and co-occurring conditions: The role of endopheno-types. Int J Eat Disord 2007; 40: S76–S78

    Article  PubMed  Google Scholar 

  34. Gottesman I, Gould T. The endophenotype concept in psychiatry: Etymology and strategic intentions. Am J Psychiatry 2003; 160: 636–645

    Article  PubMed  Google Scholar 

  35. Connan F, Campbell I, Katzman M, et al. A neurodevelopmen-tal model for anorexia nervosa. Physiol Behav 2003; 79: 13–24

    Article  PubMed  CAS  Google Scholar 

  36. Strober M. Pathologic fear conditioning and anorexia ner-vosa: On the search for novel paradigms. Int J Eat Disord 2004; 35: 504–508

    Article  PubMed  Google Scholar 

  37. Steinglass J, Walsh B. Habit learning and anorexia nervosa: A cognitive neuroscience hypothesis. Int J Eat Disord 2006; 39: 267–275

    Article  PubMed  Google Scholar 

  38. Wade T, Tiggemann M, Bulik C, et al. Shared temperament risk factors for anorexia nervosa: A twin study. Psychol Med 2008; 70: 239–244

    Article  Google Scholar 

  39. Kaye WH, Gwirtsman HE, George DT, et al. Altered serotonin activity in anorexia nervosa after long-term weight restoration. Does elevated cerebrospinal fluid 5-hydroxyin-doleacetic acid level correlate with rigid and obsessive behavior? Arch Gen Psychiatry 1991; 48: 556–562

    CAS  Google Scholar 

  40. Frank GK, Kaye WH, Meltzer CC, et al. Reduced 5-HT2A receptor binding after recovery from anorexia nervosa. Biol Psychiatry 2002; 52: 896–906

    Article  PubMed  CAS  Google Scholar 

  41. Bailer U, Price J, Meltzer C, et al. Altered 5-HT(2A) receptor binding after recovery from bulimia-type anorexia nervosa: Relationships to harm avoidance and drive for thinness. Neuropsychopharmacology 2004; 29: 1143–1155

    Article  PubMed  CAS  Google Scholar 

  42. Frank G, Bailer U, Henry S, et al. Increased dopamine D2/ D3 receptor binding after recovery from anorexia nervosa measured by positron emission tomography and [11c]raclo-pride. Biol Psychiatry 2005; 58: 908–912

    Article  PubMed  CAS  Google Scholar 

  43. Uher R, Brammer MJ, Murphy T, et al. Recovery and chro-nicity in anorexia nervosa: Brain activity associated with differential outcomes. Biol Psychiatry 2003; 54: 934–942

    Article  PubMed  Google Scholar 

  44. Tchanturia K, Morris R, Anderluh M, et al. Set shifting in anorexia nervosa: An examination before and after weight gain, in full recovery and relationship to childhood and adult OCPD traits. J Psychiatr Res2004; 38: 545–552

    Article  PubMed  CAS  Google Scholar 

  45. Roberts ME, Tchanturia K, Stahl D, et al. A systematic review and meta-analysis of set shifting ability in eating disorders. Psychol Med 2007; 37: 1075–1084

    Article  PubMed  Google Scholar 

  46. Lopez C, Tchanturia K, Stahl D, et al. Weak central coherence in eating disorders: A step towards looking for an endophenotype of eating disorders. J Clin Exp Neuropsychol 2008 (in press). doi 10.1080/13803390802036092

    Google Scholar 

  47. Holliday J, Tchanturia K, Landau S, et al. Is impaired set-shifting an endophenotype of anorexia nervosa? Am J Psychiatry 2005; 162: 2269–2275.

    Article  PubMed  Google Scholar 

  48. Steiger H, Gauvin L, Joober R, et al. Intrafamilial correspondences on platelet [3H-]paroxetine-binding indices in bulimic probands and their unaffected first-degree relatives. Neuropsychopharmacology 2006; 31: 1785–1792

    Article  PubMed  CAS  Google Scholar 

  49. Lopez C, Tchanturia K, Stahl D, et al. An examination of the concept of central coherence in women with anorexia ner-vosa. Int J Eat Disord 2008; 41: 143–152

    Article  PubMed  Google Scholar 

  50. Kaye W. Neurobiology of anorexia and bulimia nervosa. Physiol Behav 2008; 94: 121–135

    Article  PubMed  CAS  Google Scholar 

  51. Bailer UF, Frank GK, Henry SE, et al. Serotonin transporter binding after recovery from eating disorders. Psychopharmacology (Berl) 2007; 195: 315–324

    Article  CAS  Google Scholar 

  52. Goethals I, Vervaet M, Audenaert K, et al. Comparison of cortical 5-HT2A receptor binding in bulimia nervosa patients and healthy volunteers. Am J Psychiatry 2004; 161: 1916–1918

    Article  PubMed  Google Scholar 

  53. Audenaert K, Van Laere K, Dumont F, et al. Decreased 5-HT2A receptor binding in patients with anorexia nervosa. J Nucl Med 2003; 44: 163–169

    PubMed  CAS  Google Scholar 

  54. Kaye W, Frank G, Meltzer C, et al. Altered serotonin 2A receptor activity in women who have recovered from bulimia nervosa. Am J Psychiatry 2001; 158: 1152–1155

    Article  PubMed  CAS  Google Scholar 

  55. Bailer U, Frank G, Henry S, et al. Exaggerated 5-HT1A but normal 5-HT2A receptor activity in individuals ill with anorexia nervosa. Biol Psychiatry 2007; 61: 1090–1099

    Article  PubMed  CAS  Google Scholar 

  56. Bailer U, Frank G, Henry S, et al. Altered brain serotonin 5-HT1A receptor binding after recovery from anorexia ner-vosa measured by positron emission tomography and [car-bonyl11c]way-100635. Arch Gen Psychiatry 2005; 62: 1032–1041

    Article  PubMed  CAS  Google Scholar 

  57. Tiihonen J, Keski-Rahkonen A, Muhonen M, et al. Brain serotonin 1A receptor binding in bulimia nervosa. Biol Psychiatry 2004; 55: 871–873

    Article  PubMed  CAS  Google Scholar 

  58. Tauscher J, Pirker W, Willeit M, et al. [123i] beta-CIT and single photon emission computed tomography reveal reduced brain serotonin transporter availability in bulimia nervosa. Biol Psychiatry 2001; 49: 326–332

    Article  PubMed  CAS  Google Scholar 

  59. Wagner A, Aizenstein H, Venkatraman VK, et al. Altered reward processing in women recovered from anorexia ner-vosa. Am J Psychiatry 2007; 164: 1842–1849

    Article  PubMed  Google Scholar 

  60. Johansson L, Ghaderi A, Anderson G. Stroop interference for food — and body — related words: A meta-analysis. Eat Behav 2005; 6: 271–281

    Article  PubMed  Google Scholar 

  61. Dobson KS, Dozoi DJ. Attentional biases in eating disorders: A meta-analytic review of stroop performance. Clin Psychol Rev 2004; 23: 1001–1022

    Article  PubMed  Google Scholar 

  62. Lovell D, Williams J, Hill A. Selective processing of shape-related words in women with eating disorders, and those who have recovered. Br J Clin Psychol 1997; 36: 421–432

    PubMed  Google Scholar 

  63. Miyake A, Freidman NP, Emerson MJ, et al. The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognit Psychol 2000; 41: 49–100

    Article  PubMed  CAS  Google Scholar 

  64. Tchanturia K, Morris R, Surguladze S, et al. An examination of perceptual and cognitive set shifting tasks in acute anorexia nervosa and following recovery. Eating Weight Disord 2002; 7: 312–315

    CAS  Google Scholar 

  65. Tchanturia K, Serpell L, Troop N, et al. Perceptual illusions in eating disorders: Rigid and fluctuating styles. J Behav Ther Exp Psychiatry 2001; 32: 107–115

    Article  PubMed  CAS  Google Scholar 

  66. Steinglass JE, Walsh T, Stern Y. Set shifting deficit in anorexia nervosa. Int J Eat Disord 2006; 12: 431–435

    Google Scholar 

  67. Tchanturia K, Anderluh M, Morris R, et al. Cognitive flexi-bility in anorexia nervosa and bulimia nervosa. J Int Neuropsychol Soc 2004; 10: 513–520

    Article  PubMed  Google Scholar 

  68. Frith U. Autism: Explaining the enigma. Oxford: Basil Blackwell; 1989

    Google Scholar 

  69. Happé F, Frith U. The weak coherence account: Detail-focused cognitive style in autism spectrum disorders. J Autism Dev Disord 2006; 36: 5–25

    Article  PubMed  Google Scholar 

  70. Happé F, Booth R. The power of the positive: Revisiting weak coherence in autism spectrum disorders. Q J Exp Psychol (Colchester) 2008; 61: 50–63

    Article  Google Scholar 

  71. Smalley S, Asarnov R. Brief report: Cogntive subclinical markers in autism. J Autism Dev Disord 1990; 20: 271–278

    Article  PubMed  CAS  Google Scholar 

  72. Happé F, Briskman J, Frith U. Exploring the cognitive phe-notype of autism: Weak “Central coherence” In parents and siblings of children with autism: I.Experimental tests. J Child Psychol Psychiatry 2001; 42: 299–307

    Article  PubMed  Google Scholar 

  73. Baron-Cohen S, Hammer J. Parents of children with asperger syndrome: What is the cognitive phenotype? J Cogn Neurosci 1997; 9: 548–554

    Article  Google Scholar 

  74. Gillberg I, Gillberg C, Rastam M, et al. The cognitive profile of anorexia nervosa: A comparative study including a community-based sample. Compr Psychiatry 1996; 37: 23–30

    Article  PubMed  CAS  Google Scholar 

  75. Gillberg I, Rastam M, Wentz E, et al. Cognitive and executive functions in anorexia nervosa ten years after onset of eating disorder. J Clin Exp Neuropsychol 2007; 29: 170–178

    Article  PubMed  Google Scholar 

  76. Lopez C, Tchanturia K, Stahl D, et al. Central coherence in women with bulimia nervosa. Int J Eat Disord 2008; 41: 340–347

    Article  PubMed  Google Scholar 

  77. Lopez C, Tchanturia K, Stahl D, et al. Central coherence in eating disorders: A systematic review. Psychol Med 2008; 38: 1393–1404

    Article  PubMed  CAS  Google Scholar 

  78. Zonnevylle-Bender M, van Goozen S, Cohen-Kettenis P, et al. Emotional functioning in anorexia nervosa patients: Adolescents compared to adults. Depress Anxiety 2004; 19: 35–42

    Article  PubMed  Google Scholar 

  79. Zonnevylle-Bender M, van Goozen S, Cohen-Kettenis P, et al. Emotional functioning in adolescent anorexia nervosa patients: A controlled study. Eur Child Adolesc Psychiatry 2004; 13: 28–34

    Article  PubMed  Google Scholar 

  80. Zonnevijlle-Bender M, van Goozen S, Cohen-Kettenis P, et al. Do adolescent anorexia nervosa patients have deficits in emotional functioning? Eur Child Adolecent Psychiatry 2002; 11: 38–42

    Article  CAS  Google Scholar 

  81. Kucharska-Pietura K, Nikolaou V, Masiak M, et al. The recognition of emotion in the faces and voice of anorexia ner-vosa. Int J Eat Disord 2004; 35: 42–47

    Article  PubMed  Google Scholar 

  82. Hambrook D, Tchanturia K, Schmidt U, et al. Empathy, sys-temazing, and autistic traits in anorexia nervosa: A pilot study. Br J Clin Psychol 2008; 47: 335–339

    Article  PubMed  Google Scholar 

  83. Wagner A, Barbarich-Marsteller NC, Frank GK, et al. Personality traits after recovery from eating disorders: Do subtypes differ? Int J Eat Disord 2006; 39: 276–284

    Article  PubMed  Google Scholar 

  84. Strober M, Freeman R, Lampert C, et al. The association of anxiety disorders and obsessive compulsive personality disorder with anorexia nervosa: Evidence from a family study with discussion of nosological and neurodevelopmental implications. Int J Eat Disord 2007; 40: S46–S51

    Article  PubMed  Google Scholar 

  85. Tchanturia K, Whitney J, Treasure J. Can cognitive exercises help treat anorexia nervosa? Eating Weight Disord 2006; 11: e112–116

    CAS  Google Scholar 

  86. Tchanturia K, Davies H, Lopez C, et al. Neuropsychological task performance before and after cognitive remediation in anorexia nervosa: A pilot case series. Psychol Med 2008; 38: 1371–1373

    Article  PubMed  Google Scholar 

  87. Lopez C, Roberts ME, Tchanturia K, et al. Using neuropsy-chological feedback therapeutically in treatment for anorexia nervosa: Two illustrative case reports. Eur Eat Disord Rev 2008; 16: 411–420

    Article  PubMed  Google Scholar 

  88. Lopez CA, Roberts ME, Sepulveda AR, et al. Using an evidence based approach to develop new tailored treatment for anorexia nervosa. In Buckroyd J and Rother S, eds. Psychological Responses to Eating Disorders. Chichester: Wiley; 2008: 39–54

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Lopez, C., Roberts, M., Treasure, J. (2009). Biomarkers and Endophenotypes in Eating Disorders. In: Ritsner, M.S. (eds) The Handbook of Neuropsychiatric Biomarkers, Endophenotypes and Genes. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-9464-4_16

Download citation

Publish with us

Policies and ethics