title: Association between serotonin transporter gene polymorphism and eating disorders outcome: a 6-year follow-up study.
abstract: Eating disorder patients show different long-term outcomes, and trait-related alterations of serotonergic function, which might be related with the serotonin transporter (5-HTT) gene. We studied the relationships between 5-HTTLPR polymorphism, eating specific and general psychopathology and the long-term outcome of anorexia nervosa (AN) and bulimia nervosa (BN) patients. We evaluated the distribution of the functional 5-HTTLPR polymorphism in a series of 201 Italian, Caucasian, eating disorder patients (113 with AN and 88 with BN binge/purging (BP subtype) and in 150 Caucasian unrelated controls. Prior to starting an individual cognitive behavior therapy, a clinical assessment was performed by means of the structured clinical interview for DSM-IV axis I disorders and several self-report questionnaires. This assessment was repeated at the end of treatment, 3 years after the end of treatment and 3 years after the first follow-up. Diagnostic changes between AN and BN were frequent (28.3%), and the presence of depressive disorders was associated with a higher rate of diagnostic crossover during the follow-up period. The S-allele of the 5-HTTLPR genotype increases the risk susceptibility for both depressive comorbidity (OR = 4.23; 95% CI, 1.45-12.37) and diagnostic crossover during the follow-up period in AN patients (OR = 5.04; 95% CI, 1.69-14.98). Logistic regression analyses confirmed these findings, when the interaction between genotype and psychiatric comorbidity as predictors of diagnostic instability in AN patients were taken into account. No significant association was found between 5-HTTLPR genotype and recovery. The S-allele of the 5-HTTLPR genotype increases the risk for depressive disorders comorbidity, and moderates the long-term outcome of anorectic patients.
authors.affiliation: Department of Neurological and Psychiatric Sciences, University of Florence, Largo Brambilla, Florence, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Castellini
authors.forename: Valdo
authors.initials: V
authors.lastname: Ricca
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lelli
authors.forename: Silvia
authors.initials: S
authors.lastname: Bagnoli
authors.forename: Ersilia
authors.initials: E
authors.lastname: Lucenteforte
authors.forename: Carlo
authors.initials: C
authors.lastname: Faravelli
authors.forename: Sandro
authors.initials: S
authors.lastname: Sorbi
authors.forename: Benedetta
authors.initials: B
authors.lastname: Nacmias
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D016015:Logistic Models; D008297:Male; D011110:Polymorphism, Genetic; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D016896:Treatment Outcome
chemical_list: C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins