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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n\u003Cp id=\u0022p-1\u0022\u003EThis article discusses the latest data and trends in the field of eating disorder research including an evaluation of the dysregulation of the serotoninergic (5-HT) and dopaminergic system in individuals recovered from anorexia or bulimia nervosa, an overview of a Cognitive Interpersonal Maintenance Model for the treatment of anorexia, and recent advances in the psychopharmacological management of eating disorders among other topics.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ESomatoform Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EEating Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EEating Disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EAt this year\u0027s APA annual meeting, a group of leading investigators gathered to discuss the latest data and trends in the field of Eating Disorder research.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/2\/30\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-377045538\u0022 data-figure-caption=\u0022\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure1\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/2\/30\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/2\/30\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure1\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/7\/2\/30\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11007\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-3\u0022\u003EUsing Positron Emission Tomography, University of Pittsburgh School of Medicine researcher Walter Kaye, MD, evaluated dysregulation of the serotoninergic (5-HT) and dopaminergic (DA) system in individuals recovered from anorexia or bulimia nervosa (Kaye WH et al. \u003Cem\u003EPhysio Behav\u003C\/em\u003E 2005;86:15\u20137).\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EResults of this study showed patients who have recovered from anorexia nervosa to have elevated 5-HT receptor activity, especially in the 5-HT\u003Csub\u003E1A\u003C\/sub\u003E and \u003Csub\u003E1B\u003C\/sub\u003E types. Furthermore, although recovered anorexic patients had elevated 5-HT transporter activity, 5-HT transporter activity in bulimic patients was reduced. In the context of DA, recovered anorexic patients showed elevated DA\u003Csub\u003E2\u003C\/sub\u003E receptor activity in the brain\u0027s reward system. This data lends strong evidence to the position that dysregulation of the 5-HT and DA systems is intimately involved in the etiology of eating disorders. Dr. Kaye suggests that these two neuro-pathways may be related to \u201caltered anxiety, obssessionality, appetite, impulse dyscontrol and body image distortions\u201d.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EIn his talk, Ulrike Schmidt, MD, of London\u0027s Institute of Psychiatry, provided an overview of a Cognitive Interpersonal Maintenance Model for the treatment of anorexia. Based on data indicating that anorexics perform significantly worse on tasks measuring attention to detail and cognitive shifting strategies [eg, the Embedded Figure (p\u0026lt;0.05) and Wisconsin Card Sorting Task (Roberts ME et al. \u003Cem\u003EPsychol Med\u003C\/em\u003E 2007;30:1\u201312], four specific targets for intervention should be highlighted. Specifically, clinicians must address: a) obsessive compulsive personality disorder traits, b) avoidance of emotions and social situations, c) pro-anorexia beliefs, as well as d) response of \u201cclose others\u201d. These issues may be dealt with by providing cognitive remediation and trait feedback.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EFollowing the overview on treatment options for anorexic patients, Ulrike also presented data on a randomized controlled trial for the effectiveness of Family Therapy versus Guided Self Care in patients with Bulimia Nervosa (Schmidt U et al. \u003Cem\u003EAm J Psychiatry\u003C\/em\u003E 2007; l164:591\u20138). In the context of \u201cbingeing\u201d, Guided Self Care was more effective than Family Therapy at reducing the number of episodes in this population 6 months into treatment (p\u0026lt;0.001). This difference dissipated by the 12-month follow-up\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003ETimothy Walsh, MD, Columbia University, highlighted recent advances in the psychopharmacological management of eating disorders. Although the pharmacological treatment of bulimia is well established, primarily the use of antidepressants, the effectiveness of medication in the treatment of anorexia nervosa is more uncertain. For example, the data evaluating the effectiveness of the selective serotonin reuptake inhibitor, fluoxetine, in prolonging time to relapse is not encouraging. Ninety three (93), recovered subjects were utilized in this two site (Toronto, Canada and New York, New York) study. Although survival rates within the study differed between the two sites (survival was greater in Canada; p=0.005), fluoxetine, overall, did not prolong time to relapse.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EDespite these negative findings, results from a study with the atypical antipsychotic, olanzapine, suggest greater efficacy in treating anorexia nervosa with this drug. In a 13-week trial, 34 day-treatment patients with anorexia nervosa were given olanzapine and monitored for weight gain. It was reported that patients on olanzapine had a faster rate of weight gain as compared to those patients receiving day-treatment only (p=0.04). These results should be interpreted cautiously, notes Dr. Walsh. No medication is clearly effective for anorexia nervosa and that the best treatment remains caloric intake.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EIn the final address of the session, Annemarie van Elburg, MD, Reintveld Center for Eating Disorders, the Netherlands, compared and contrasted eating disorders in children and adolescents. In children, the most common eating disorders include food avoidance emotional disorder, functional dysphagia, pervasive refusal syndrome and early anorexia nervosa. Adolescents commonly present with the more classical eating disorders of anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified and emetophobia. One central question is whether the age of onset of eating disorders is getting younger. Although, no clear biological underpinning has been identified, the anecdotal correlation between puberty and the onset of a full blown eating disorder suggests a neuroendocrinological trigger and provides an opportunity for future investigations.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2007 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/7\/2\/30.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzlyfe\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlyfe\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}