Methylation of the glucocorticoid receptor gene promoter in bulimic women: Associations with borderline personality disorder,suicidality, and exposure to childhood abuse

Objective:

To compare levels of methylation of the glucocorticoid receptor (GR) gene (NR3C1) promoter between women with bulimia nervosa (BN) and women with no eating disorder (ED), and also to explore, in women with BN, the extent to which methylation of the GR gene promoter corresponds to childhood abuse, suicidality, or borderline personality disorder (BPD).

Method:

We measured methylation levels in selected NR3C1 promoter regions using DNA obtained from lymphocytes in 64 women with BN (32 selected as having a history of severe childhood abuse and 32 selected as having no such history) and 32 comparison women with no ED or history of childhood abuse.

Results:

Compared to noneating disordered women, women with BN and comorbid BPD (or BN with a history of suicidality) showed significantly more methylation of specific exon 1C sites. There was also a (nonsignificant) result indicative of greater methylation in some 1C sites among women with BN, when compared (as a group) to women with no ED. No parallel effects owing to childhood abuse were observed.

Discussion:

Our findings associate BN (when accompanied by BPD or suicidality) with hypermethylation of certain GR exon 1C promoter sites. We discuss theoretical and clinical implications of our findings. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013)     

Anorexia nervosa with comorbid psychosis and borderline mental retardation: a case report

Anorexia nervosa (AN) is often associated with comorbid depression or anxiety, but rarely with mental retardation or psychosis. METHODS: The present report describes the case of a 22 year-old woman who met diagnostic criteria for anorexia nervosa, borderline mental retardation, and schizoaffective disorder. RESULTS AND DISCUSSION: The case highlights the difficulties in differential diagnosis with these seemingly incompatible disorders. It also provides some insights into the unclear relationship between anorexia nervosa and these comorbid conditions.     

Accuracy of reported weight and menstrual status in teenage girls with eating disorders

OBJECTIVE: The current study investigated the accuracy of reported current and historical weights and of menstrual status in teenage girls with eating disorders. METHOD: Reported current weight in one interview was compared with measured weight at another occasion. Reported historical weights were compared with documented weights from growth charts of the school health services. Reports of menstrual status from two different interviews were compared. RESULTS: The overall correlation between reported and measured/documented weight was high. Current weight was reported with high accuracy in all diagnostic groups and without tendencies to underreport. Patients with bulimia nervosa, but not those with anorexia nervosa, underreported their historical top weight. The most common reason for large discrepancies between reported and documented historical weights was that the two weights compared referred to different time points. The reports on menstrual status were divergent for 13% of the patients, most notably 4 of 15 patients on oral contraceptives had been categorized as having menstruations in one of the interviews. CONCLUSION: Reported weight history and menstrual status are of high accuracy in teenage girls with eating disorders.