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

Claire Gauthier, Christine Hassler, Lama Mattar, Jean-Marie Launay, Jacques Callebert, Howard Steiger, Jean-Claude Melchior, Bruno Falissard, Sylvie Berthoz, Virginie Mourier-Soleillant, François Lang, Marc Delorme, Xavier Pommereau, Priscille Gerardin, Stephanie Bioulac, Manuel Bouvard, Nathalie Godart
Psychoneuroendocrinology. 2014-01-01; 39: 170-178
DOI: 10.1016/j.psyneuen.2013.09.009

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1. Psychoneuroendocrinology. 2014 Jan;39:170-8. 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, Mattar L, Launay JM, Callebert J, Steiger H, Melchior
JC, Falissard B, Berthoz S, Mourier-Soleillant V, Lang F, Delorme M, Pommereau X,
Gerardin P, Bioulac S, Bouvard M; EVHAN Group, Godart N.

Collaborators: Godart N, Berthoz S, Duclos J, Mattar L, Roux H, Thiébaud MR,
Lalanne C, Vibert S, Hubert T, Courty A, Ringuenet D, Benoit JP, Blanchet C, Moro
MR, Bignami L, Nordon C, Rouillon F, Cook S, Doyen C, Siméoni MC, Gerardin P,
Lebecq S, Podlipski MA, Gayet C, Lasfar M, Delorme M, Pommereau X, Bioulac S,
Bouvard, Carrere J, Doncieux K, Faucher S, Fayollet C, Prexl A, Billard S, Lang
F, Mourier-Soleillant V, Greiner R, Gay A, Carrot G, Lambert S, Rousselet M,
Placé L, Venisse JL, Bronnec M, Falissard B, Genolini C, Hassler C, Tréluyer JM,
Chacornac O, Delattre M, Moulopo N, Turuban C, Auger C.

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:

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]

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