Symptoms of depression and anxiety in anorexia nervosa: Links with plasma tryptophan and serotonin metabolism

1. Psychoneuroendocrinology. 2014 Jan;39:170-178. doi:
10.1016/j.psyneuen.2013.09.009. Epub 2013 Sep 17.

Symptoms of depression and anxiety in anorexia nervosa: links with plasma
tryptophan and serotonin metabolism.

Gauthier C(1), Hassler C(2), Mattar L(3), Launay JM(4), Callebert J(4), Steiger
H(5), Melchior JC(6), Falissard B(2), Berthoz S(3), Mourier-Soleillant V(7),
Lang F(7), Delorme M(8), Pommereau X(8), Gerardin P(9), Bioulac S(10), Bouvard
M(10); EVHAN Group; Godart N(11).

Author information:
(1)Département de Psychiatrie, Institut Mutualiste Montsouris, Paris, France;
Faculté de Médecine, Université Paris Descartes, Paris, France; Inserm U669,
Paris, Université Paris Descartes, Paris, France. Electronic address:
.
(2)Inserm U669, Paris, Université Paris Descartes, Paris, France.
(3)Département de Psychiatrie, Institut Mutualiste Montsouris, Paris, France;
Faculté de Médecine, Université Paris Descartes, Paris, France; Inserm U669,
Paris, Université Paris Descartes, Paris, France.
(4)APHP, Hôpital Lariboisière, Service de Biochimie et de Biologie Moléculaire,
Paris, France; INSERM U942, Biomarqueurs et Insuffisance cardiaque, Hôpital
Lariboisière, Paris, France.
(5)Eating Disorders Program, Douglas University Institute, Verdun, Quebec,
Canada; Psychiatry Department, McGill University, Montreal, Quebec, Canada.
(6)Unité de Nutrition clinique-Maladies infectieuses, Département de médecine
aiguë spécialisée, Hôpital Raymond Poincarré, Garches, France.
(7)Unité de Psychiatre, CHU Hôpital Nord, Saint-Etienne, France.
(8)Unité médico-psychologique de l’adolescent et du jeune adulte, CHU de
Bordeaux, Bordeaux, France.
(9)Département de pédiatrie Médicale – Psychiatrie de l’enfant et de
l’adolescent, CHU de Rouen, Rouen, France.
(10)C H S Charles Perrens, Bordeaux, France.
(11)Département de Psychiatrie, Institut Mutualiste Montsouris, Paris, France;
Faculté de Médecine, Université Paris Descartes, Paris, France; Inserm U669,
Paris, Université Paris Descartes, Paris, France. Electronic address:
.

Depressive, anxiety and obsessive symptoms frequently co-occur with anorexia
nervosa (AN). The relationship between these clinical manifestations and the
biological changes caused by starvation is not well understood. It has been
hypothesised that reduced availability of tryptophan (TRP) could reduce
serotonin activity and thus trigger these comorbid symptoms. The aim of this
study, during re-feeding in individuals with AN, was to analyse covariations
across measures of nutritional status, depressive and anxiety symptoms, and
peripheral serotonin markers. Depressive and anxiety symptoms, nutritional
status and serotonin markers–whole blood serotonin content, plasma TRP and the
ratio between TRP and large neutral amino acids–were assessed for 42 AN
participants at admission to inpatient treatment and after re-feeding.
Biological measures were compared to those obtained in 42 non-eating disordered
subjects. For those with AN, psychological, nutritional and biological
parameters improved significantly during hospitalisation. Levels of serotonin
markers were significantly lower in the AN group compared to the control group,
at admission and at discharge. Increase in the TRP/LNAA ratio was correlated
with a decrease in depressive symptoms. In addition, there was a positive
correlation between serotonin levels and symptoms of both anxiety and depression
at discharge. We speculate that enhanced TRP availability during re-feeding, as
a result of the increase in the TRP/LNAA ratio, could restore serotonin
neurotransmission and lead to a decrease in depressive symptoms. The association
between serotonin and anxiety and depressive symptoms would be consistent with
numerous observations indicating abnormal functioning of the serotoninergic
system in AN.

Copyright © 2013 Elsevier Ltd. All rights reserved.

DOI: 10.1016/j.psyneuen.2013.09.009
PMID: 24135616 [Indexed for MEDLINE]

Auteurs Bordeaux Neurocampus