Relevance of the 5-HTTLPR polymorphism and childhood abuse to increased psychiatric comorbidity in women with bulimia-spectrum disorders.
OBJECTIVE
Individuals with bulimia nervosa have been shown to display heterogeneous profiles of comorbid psychiatric disturbance, possibly due to varying degrees of genetic and environmental vulnerability. Using information about comorbid psychiatric disturbances, we developed an empirically based classification of individuals with bulimia-spectrum disorders, and then explored whether or not the resulting phenotypes corresponded to variations in the serotonin transporter promoter polymorphism (5-HTTLPR) and exposure to childhood abuse.


METHODS
Eighty-nine women aged 17 to 49 years with DSM-IV bulimia-spectrum disorders completed questionnaires assessing eating and general psychopathologic symptoms, participated in interviews assessing Axis I disorders and childhood abuse, and provided blood samples for genotyping. Data on lifetime Axis I disorders were analyzed using latent class analysis, and resulting classes were compared on eating and psychopathologic symptoms, 5-HTTLPR genotype, and childhood abuse. The study was conducted from June 2002 to October 2006.


RESULTS
The analysis yielded a model with 2 classes: a first class labeled low comorbidity (N = 59, 66%), characterized by a high likelihood of major depressive disorder, and another class labeled high comorbidity (N = 30, 34%), characterized by a high likelihood of major depressive disorder, anxiety disorder, and substance-use disorders. The high-comorbidity class displayed significantly higher dieting preoccupations and conduct problems, and showed a greater likelihood of carrying the 5-HTTLPR S allele and of childhood abuse than did the low-comorbidity class.


CONCLUSIONS
The present results are consistent with previous findings identifying a subgroup of individuals with bulimia characterized by high psychiatric comorbidity and suggest that the 5-HTTLPR polymorphism and childhood trauma may both be pertinent to explaining the presence of greater psychiatric comorbidity in bulimia-spectrum disorders.
Richardson
Jodie
J
Eating Disorders Program, Douglas Mental Health University Institute, Montreal, Quebec, Canada. jodie.richardson@mail.mcgill.ca
Steiger
Howard
H
Schmitz
Norbert
N
Joober
Ridha
R
Bruce
Kenneth R
KR
Israel
Mimi
M
Gauvin
Lise
L
Anestin
Annelie S
AS
Dandurand
Cathy
C
Howard
Heidi
H
de Guzman
Rosherrie
R
D000293:Adolescent; D000328:Adult; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics*; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*
C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins