The 19th Annual Meeting of the Eating Disorders Research Society took place on September 19-21, 2013 in Bethesda, Maryland. Among the winners of the top-five abstract awards was "How Do We Define 'Recovery' from Anorexia Nervosa and Bulimia Nervosa at 25 Years?" This is the first paper out of the 25-year follow-up to Dr. David Herzog's NIMH-funded Longitudinal Study of Anorexia and Bulimia Nervosa.
Thursday, October 17, 2013
Update: Longitudinal Study
The 19th Annual Meeting of the Eating Disorders Research Society took place on September 19-21, 2013 in Bethesda, Maryland. Among the winners of the top-five abstract awards was "How Do We Define 'Recovery' from Anorexia Nervosa and Bulimia Nervosa at 25 Years?" This is the first paper out of the 25-year follow-up to Dr. David Herzog's NIMH-funded Longitudinal Study of Anorexia and Bulimia Nervosa.
Monday, June 24, 2013
Eating Disorder Symptoms: Differences among Ethnic Groups
Dr.
David Herzog, Emeritus Professor of Psychiatry at Harvard Medical School, is an
internationally renowned expert on eating disorders. He founded and directed the Harvard Eating
Disorders Center, which later became the Harris Center for Education and
Advocacy in Eating Disorders at Massachusetts General Hospital.
Detection
of high-risk attitudes and behaviors is critical in the goal of preventing
eating disorders. In 1996, the National Eating Disorders Screening Program
(NEDSP) was launched on 409 college campuses across the United States. The
NEDSP reached a diverse student population and used a self-report screening
questionnaire to identify those at risk for eating disorders. NEDSP participants were offered an
opportunity to meet with an on-site counselor to review their responses to the
questionnaire in order to receive a recommendation for what, if any, further
clinical evaluation would be necessary.
Dr. Herzog and his team analyzed
data from 5,435 NEDSP questionnaires for a study of ethnic differences in the
prevalence of eating disorder symptoms and related distress. Questionnaire
items assessed the presence and frequency of restrictive eating, amenorrhea, binge eating, self-induced vomiting, use of laxatives and diuretics, and potentially problematic
exercise behaviors. Three questions were used to measure distress related to
the reported symptoms. Participants were asked to select the best response on
4-point scales ranging from ‘‘never’’ to ‘‘all of the time’’ reflecting the
degree to which eating and weight concerns (a) caused a great deal of distress,
(b) interfered with relationships, and (c) interfered with academic/work
performance.
The frequency of binge
eating, restrictive eating, vomiting, and amenorrhea
did not differ
significantly across ethnic groups. However,
significant between-group differences were found with respect to modes of
purging. Binge correlates (such as eating until uncomfortably full) were
significantly more frequent among Caucasian than African American participants.
Binge eating was the best predictor of distress among Caucasians, African
Americans, and Latinos, whereas vomiting was the best predictor of distress
among Asians. Asian participants who used laxatives were significantly less
likely to receive a recommendation for further evaluation than non-Asian
participants.
The findings suggest
there may be some important differences among ethnic groups in regard to eating
disorder symptoms, symptom-related distress, and likelihood for referral that
merit further investigation. Clinician recognition of this
potential diversity
may enhance culturally competent care for eating disorders.
Weight Gain, Restoration of Menses, and Bone Density Change in Adolescent Girls with Anorexia Nervosa
Dr. David Herzog—Emeritus Professor of Psychiatry at Harvard
Medical School—founded the Harvard Eating Disorders Center in 1994, which later
became the Harris Center at Massachusetts General Hospital (MGH). For over 25 years, Dr. Herzog has collaborated
with the Neuroendocrine Unit at MGH to learn more about the biology of eating
disorders. This team found that bone loss is a serious complication for most
adolescents with anorexia nervosa, placing them at increased risk of
debilitating fractures.
Dr. Herzog
and his colleagues in the Neuroendocrine Unit went on to conduct a prospective,
observational study on the effects of weight gain and menstrual recovery on
measures of bone mineral density. Sixty-seven girls between the ages of 12 and
18 participated; thirty-four of the girls had anorexia nervosa and 33 were
healthy controls. Dual energy x-ray absorptiometry (DXA) was used to measure
participants’ lumbar and whole-body bone density at baseline and at 6 and 12
months.
Weight gain was defined as a 10% increase
in body mass index and menstrual recovery as three menses or more in the previous
6 months. The 34 subjects with anorexia were characterized as AN recovered (AN-recovered)
if they had both weight gain and menstrual recovery (n=14) and as AN not
recovered (AN-not recovered) if they did not have both weight gain and
menstrual recovery (n=20). Median duration of recovery was 9 months.
The girls with anorexia had lower
spine bone mineral content for bone area and lower whole-body bone area for
height, compared with controls. Weight
gain and menstrual recovery in anorexia (AN-recovered) resulted in
stabilization of bone mineral density measures, whereas bone density continued
to decline in those with anorexia who did not gain weight and resume their menses
(AN-not recovered). AN-recovered also predicted greater increases in spine bone
mineral content for bone area and whole-body bone area, compared with AN-not recovered.
The data indicate that weight gain
and menstrual recovery are associated with a halting of deterioration in bone
measures, even in the short term. This raises the question of whether sustained
recovery would result in significant increases in bone density parameters. The
findings underscore the importance of optimizing weight gain in adolescents
with anorexia and highlight the beneficial effects of even short-term weight
increase with resumption of menses.
Bone Metabolism in Adolescent Boys with Anorexia Nervosa
For over 25 years, Dr. David Herzog,
Emeritus Professor of Psychiatry at Harvard Medical School, has worked closely
with the Neuroendocrine Unit at
Massachusetts General Hospital (MGH) to better understand the
biology of eating disorders. Research conducted by this team found that bone
loss is a serious complication for the majority of adolescent girls and adult
women with anorexia nervosa, placing them at increased risk of fracture and
permanent disability.
Dr.
Herzog and his team in the Neuroendocrine Unit went on to conduct the first
controlled study of bone mineral density in boys with anorexia. Thirty-four
boys between the ages of 12 and 19 participated; seventeen of the boys had
anorexia nervosa and 17 were healthy controls.
Dual energy
x-ray absorptiometry (DXA) was used to measure participants’ bone density.
Blood was drawn for IGF-1 (insulin-like growth factor 1); testosterone; SHBG (sex hormone-binding globulin); estradiol (a
main form of estrogen); the appetite-regulating hormones ghrelin, PYY, and leptin;
and biochemical markers of bone formation and bone resorption. The participants
completed questionnaires that assessed their food intake and levels of physical
activity.
The boys with anorexia nervosa had
lower bone mineral density at the spine, hip, femoral neck, trochanter,
intertrochanteric region, and whole body, compared with controls. The hip and
its subregions were affected by low bone density at least as severely as the
spine. The markers of bone formation and bone resorption were reduced in the
boys with anorexia compared with controls, who were in a state of increased
bone turnover. Low body mass index and lean mass and low testosterone levels
were important predictors of low bone mineral density.
The findings of this study are
concerning for low bone mineral density and possibly a decreased rate of bone
mass accrual during adolescence, a period characterized by marked increases
in bone accrual toward achievement of
peak bone mass. This raises questions regarding bone health and fracture risk
in later life. Because body mass index
is a key predictor of low bone density, emphasizing weight recovery is
critical.
Thursday, June 20, 2013
Pregnancy and Eating Disorders
Dr. David
Herzog was the first Endowed Professor of Psychiatry in the Field of Eating
Disorders at Harvard Medical School. He is board certified in pediatrics, child
and adolescent psychiatry and general psychiatry and has treated over 3,000
individuals with anorexia nervosa, bulimia nervosa, and associated diagnoses.
Dr. Herzog founded and directed the Harvard Eating Disorders Center, which
later became the Harris Center for Education and Advocacy in Eating Disorders
at Massachusetts General Hospital.
As part of the Longitudinal Study,
Dr. Herzog and his team examined the course of pregnancy and neonatal status
for babies born to women with eating disorders. Forty-nine live births were
included. The participants were
interviewed by trained assistants and completed a brief self-report
questionnaire that assessed both birth statistics and birth-related
complications. Medical records and/or self-report data describing the babies’
birth status were obtained.
In 1987, Dr
Herzog initiated his National Institute of Mental Health-funded Longitudinal
Study of Anorexia and Bulimia Nervosa, mapping the course and outcome in 246
women followed at frequent intervals. The Longitudinal Study – the largest and most extensive of its kind – has provided
a better understanding of how anorexia and bulimia progress, including rates of
recovery and relapse, medical consequences, associated psychiatric illnesses,
the quality of patients’ relationships, and functioning at school or at work.
The
researchers found that women with eating disorders who regain their health
prior to conception and remain nutritionally stable throughout pregnancy are
not more prone to obstetrical problems than those who have never had an eating
disorder. However, engaging in abnormal weight control behaviors during
pregnancy can increase the risk of complications such as miscarriage, premature
delivery, Cesarean delivery, low-birth-weight babies, and postpartum
depression.
The results of this study emphasized
the importance of viewing pregnant women with past or current eating disorders
as high risk and monitoring them closely both during and after pregnancy to
optimize maternal and fetal outcomes.
Tuesday, June 18, 2013
Weight Suppression and Bulimia Nervosa
Dr. David Herzog, Emeritus Professor of Psychiatry at Harvard Medical School, is a renowned expert on eating disorders. He is a distinguished researcher, teacher, clinician and advocate and is the recipient of many honors and awards. Dr. Herzog was the first Endowed Professor of Psychiatry in the Field of Eating Disorders at Harvard Medical School. In 1994, he founded the Harvard Eating Disorders Center, which later became the Harris Center for Education and Advocacy in Eating Disorders at Massachusetts General Hospital.
Dr. Herzog collaborated with
researchers at Drexel University in Philadelphia to investigate the role of
weight suppression in predicting recovery or relapse in bulimia nervosa. Weight suppression is defined as the
difference between a patient’s past highest weight and her weight at entry into
the study. The participants were 110 women with bulimia nervosa from Dr.
Herzog’s National Institute of Mental Health-funded Longitudinal Study. At study entry, these 110 participants were,
on average, 25 years old and had been ill for an average of 6 years. The
researchers collected data by interviewing the women at 6-12 month intervals over
8 years about their eating behaviors, mood symptoms, and general life
functioning.
Weight suppression was significantly
associated with time to first full remission, indicating that women who were
more weight-suppressed at study entry took longer to recover. These results support
previous research suggesting that high weight suppression may fuel binge eating
and make weight gain more likely. Future research is needed to explore methods
of improving treatment outcome for highly weight-suppressed individuals with
bulimia nervosa.
Thursday, June 13, 2013
Anorexia Nervosa and Stigma
Dr.
David Herzog, Emeritus Professor of Psychiatry at Harvard Medical School, is an
internationally respected scholar on eating disorders credited with over 280
publications. He is board certified in pediatrics, child and adolescent
psychiatry, and general psychiatry and has treated over 3,000 individuals with
eating disorders such as anorexia and bulimia
nervosa. He founded and directed the Harris Center for Education and
Advocacy in Eating Disorders at Massachusetts General Hospital and, prior to
that, the Harvard Eating Disorders Center.
Dr. David Herzog and his
staff collaborated with Boston University to explore public stigma associated with eating disorders. In 2010, 173 college students were
shown one of three videos describing anorexia as a product of either biology,
culture, or an interaction between the two.
Each video ran about 5 minutes and
consisted of two parts. All three videos opened with the same two-minute
segment, in which an average-weight actress portrays a young woman who has
recovered from anorexia. She describes her descent into the disorder and the
suffering she experienced while actively ill, including her self-loathing,
impaired concentration, physical consequences, obsessionality, and social
isolation. She also discusses her attempts to appear fine to the outside world
while feeling miserable inside.
The second part of each video varied
by condition, but each consisted of a three-minute segment in which a
middle-aged actor portrays a doctor who is an expert on anorexia nervosa. In
all conditions, the basic structure of the segment was the same, though specific
content varied. First, the doctor describes the seriousness of anorexia. Next,
he indicates that much debate surrounds the etiology of anorexia but that a
great deal of evidence points to the role of (biological/sociocultural/both
biological and sociocultural) factors in the development of the disorder.
Then, he elaborates the research evidence supporting the roles of
(biology/society/an interaction between biology and society) in the
development of the disorder.
Finally, in each video, the expert
states that anorexia can be treated but often requires a team of doctors and
sometimes occurs in the context of hospitalization. He also says that "adequate
insurance coverage and other supports for those with this disease are very much
needed."
After watching the
videos, the participants completed a questionnaire designed to measure which
explanation evoked the least stigmatizing attitudes. Those who viewed the
interaction video demonstrated less stigma than those who viewed the
sociocultural video but more than those who viewed the biology video. The stigma against anorexia tended
to be blame-based, meaning that the disorder was seen as the patient’s own
doing. Both the biological and the
interaction groups showed more intention to engage in helping behavior than the
sociocultural group.
The
preponderance of empirical evidence points to anorexia as a product of an
interaction between both biology and culture.
More research is needed to learn how to accurately portray the etiology
of the disorder while, at the same time, trying to reduce stigma.
Wednesday, June 5, 2013
Alcohol Use Disorder and Eating Disorders
Dr. David
Herzog – Emeritus Professor of Psychiatry at Harvard Medical School – has
devoted much of his career to improving the lives of individuals with eating
disorders. He founded and directed the
Harris Center for Education and Advocacy in Eating Disorders at Massachusetts
General Hospital and was the first Endowed Professor of Psychiatry in the Field
of Eating Disorders at Harvard Medical School.
Dr.
Herzog’s Longitudinal Study of Anorexia and Bulimia Nervosa is internationally
recognized as the largest and most extensive of its kind. Beginning in 1987, he and his staff followed
246 women with anorexia and bulimia, trying to determine how patients fare over
time. Who gets better and how? What factors lead to a better or worse
outcome? Data was collected by
interviewing the women every 6-12 months about their eating behaviors, physical
and emotional health, employment and relationships. The study has provided key
knowledge about how eating disorders and alcohol use disorder influence each
other.
Over one fourth of the
sample reported a lifetime history of alcohol use disorder. Ten percent of the
study subjects developed alcohol use disorder over the course of the
study. Alcohol use disorder did not influence recovery from eating disorder
symptoms; however, a number of eating disorder symptoms predicted both the
onset and recovery from an episode of alcohol use disorder. Poor psychosocial
functioning and history of substance use predicted prospective onset of
an episode of alcohol use disorder for both anorexia and bulimia. Unique
predictors for alcohol use disorder for women with anorexia were depression,
overconcern with body image, and vomiting.
For the women with anorexia nervosa, group therapy and hospitalization
were useful for recovery from an alcohol use episode. For the women with bulimia nervosa,
individual therapy and exercise shortened recovery time from an alcohol use
episode.
Dr. Herzog and his
team concluded from their
study that serious problems with alcohol are not
uncommon in patients with anorexia or bulimia, and alcohol intake should be
monitored in all patients with eating disorders, regardless of specific
diagnosis. A substantial number of
patients who initially present with an eating disorder develop alcohol problems
over the course of time, suggesting that the risk is an ongoing one.
Future research is
needed to determine the best combination of treatment modalities when eating
disorders and alcohol use disorder co-exist and to address what works best for
whom.
Tuesday, June 4, 2013
Drug Abuse in Women with Eating Disorders
Dr. David Herzog, Emeritus Professor
of Psychiatry at Harvard Medical School, founded and directed the Harvard
Eating Disorders Center, which later became the Harris Center for Education and
Advocacy in Eating Disorders at Massachusetts General Hospital. Dr. Herzog’s Longitudinal Study of Anorexia
and Bulimia Nervosa is internationally recognized as the largest and most
extensive of its kind. Beginning in 1987, he and his staff followed 246 women
with anorexia and bulimia to gain a better understanding of what happens to
patients over time. They collected data by interviewing participants every 6-12
months about their eating behaviors, physical and emotional health, work and
relationships. The study provided valuable information about the relationship
between drug use disorder and eating disorders.
Forty-two (17.1%) of
the 246 Longitudinal Study participants reported a lifetime history of drug use
disorder. Of these 42 women, 22 (52.3%) had anorexia nervosa at intake and 20
(47.7%) had bulimia at intake. Of the 22 women with anorexia with a lifetime
history of drug use disorder, 17 had a history of drug use disorder at entry
into the study and of these, 4 had a prospective onset during the study. Five
participants with anorexia developed a first episode of drug use disorder over
the course of the study. Of the 20 participants with bulimia with a lifetime
diagnosis of drug use disorder, 14 had a history of drug use disorder at intake
into the study, and of these, 4 had a prospective onset during the course of
the study, whereas 6 developed a new onset during the study.
Dr. Herzog
and his staff examined the degree to which participants who had a
prospective onset of drug use disorder during the study also carried a diagnosis
of affective disorder or alcohol use disorder during that same period. The data
indicated that 12 of 19 participants (63.2%) had a co-occurring major
depressive disorder episode and 6 of 19 participants (31.6%) had a diagnosis of
hypomania during the drug use disorder episode. Seven of 19 participants
(36.8%) had a co-occurring diagnosis of alcohol use disorder.
The most commonly
abused illicit drugs were amphetamines and cocaine (both of which have appetite
suppressant effects) and marijuana. Rates
of drug use disorder did not differ between intake diagnoses of anorexia and
bulimia. The finding that 5 of
22 participants with anorexia and 6 of 20 participants with bulimia were
diagnosed with drug use disorder for the first time over the 9-year course of
the study suggests that the risk for drug use disorder in women with eating
disorders continues over time.
Dr. Herzog and his
staff concluded from the study that drug abuse in women with eating disorders is an
area of clinical concern and should be monitored routinely throughout the
treatment process.
Monday, May 27, 2013
Effects of Risedronate and Low-Dose Testosterone Replacement Skin Patch on Bone Density in Anorexia Nervosa
Dr. David Herzog was the first Endowed Professor of Psychiatry in the Field of Eating Disorders at Harvard Medical School. For over 25 years, he has collaborated with the Neuroendocrine Unit at Massachusetts General Hospital to learn more about the biology of anorexia nervosa and interventions that affect the course of the illness. Several studies test treatments for complications such as severe bone loss, which occurs in nearly half of adult women with anorexia nervosa, increasing their risk for fractures and permanent disability.
Bone loss in adults with anorexia
nervosa is characterized by both increased bone resorption (breakdown) and decreased
formation. Risedronate is a biphosphonate, a class of drugs that slows bone
resorption and has been shown to be effective in the treatment of osteoporosis
in postmenopausal women.
Although some people think of testosterone
as existing only in men, small amounts of this hormone are also produced by
women, mostly in the ovaries. One of testosterone’s roles is to stimulate bone
formation. Testosterone levels are low in women with anorexia nervosa (as
compared to normal controls) and this deficiency is associated with abnormal
bone density.
Dr. Herzog and his team in the
Neuroendocrine Unit conducted a one-year study to determine whether therapy
with risedronate alone or in combination with a low-dose testosterone
replacement skin patch would increase bone density in women with anorexia
nervosa. 77 ambulatory women with
anorexia nervosa were randomly assigned to receive one of four treatments: 1)
risedronate 35 mg. weekly plus a placebo (inert) patch, 2) a daily low-dose
testosterone replacement skin patch plus a weekly placebo pill, 3) risedronate
35 mg. weekly plus the daily testosterone patch, or 4) double placebo. All
participants had dual energy x-ray absorptiometry (DXA) to measure their bone
density and blood tests to determine their hormone levels.
The study demonstrated that
risedronate administration increased spinal bone density, the primary site of
bone loss in women with anorexia nervosa.
Low-dose testosterone did not change bone density but increased lean
body mass. This is
an important finding
given the lack of effectiveness of other agents, including estrogen, to prevent
or reverse bone loss in adults with anorexia nervosa. Additional studies are needed to optimize
treatment for the severe bone loss experienced in this population at increased
risk for fracture.
Friday, May 24, 2013
Oxytocin is Associated with Anxiety and Depression in Anorexia Nervosa
Dr. David Herzog is an
internationally renowned eating disorders expert credited with over 280
publications and board certified in Pediatrics, Child and Adolescent Psychiatry
and General Psychiatry. Dr. Herzog was
the first Endowed Professor of Psychiatry in the Field of Eating Disorders at
Harvard Medical School. For over 25
years, he has teamed with the Neuroendocrine Unit at Massachusetts General Hospital to better understand the hormonal factors that contribute to anorexia
nervosa and to develop interventions that address complications, such as anxiety
and depression.
Produced in the hypothalamus and
secreted by the pituitary gland, the peptide hormone oxytocin helps regulate
appetite and may have properties that help alleviate anxiety and depression. Prior research by Dr. Herzog and his team found that women with anorexia nervosa have
abnormal post-meal levels of oxytocin, even after weight recovery. To follow up
on these findings, these scientists investigated the relationship between
abnormal oxytocin secretion in anorexia nervosa and psychiatric symptoms.
35 women between the ages of 18 and
28 were recruited from the community to participate in the study. 13 of these 35
had active anorexia nervosa, 9 were weight-recovered from anorexia nervosa, and
13 were healthy controls. All the
subjects were given a meal standardized for nutrient content. The participants had serial blood tests that
measured their hormone levels and completed questionnaires that assessed their
symptoms of anxiety and depression.
The study found that increased
post-meal oxytocin secretion was associated with severity of anxiety and
depressive symptoms in women with anorexia nervosa. These relationships remained
significant after the investigators controlled for the appetite-regulating
hormone cortisol, which has been implicated in anxiety and depressive symptoms
in anorexia nervosa.
The findings of the study raised the
question of whether abnormal post-meal oxytocin levels are, in part, a response
to food-induced stress in individuals with anorexia. Further research is needed to shed light on
this question.
Thursday, May 23, 2013
The Use of Psychiatric Medications in Anorexia Nervosa
Dr. David Herzog, Emeritus Professor of Psychiatry at Harvard Medical School, has collaborated with the Neuroendocrine Unit at Massachusetts General Hospital for over 25 years to better understand the hormonal factors that contribute to anorexia nervosa and the interventions that influence the course of the illness. Many of these studies have tested effective treatments for complications such as bone loss, anxiety and depression. Recently, Dr. Herzog and the team investigated the use of antidepressants, particularly SSRIs (selective serotonin reuptake inhibitors), and atypical antipsychotics from 1997 to 2009 in women with anorexia nervosa.
Overall, 53% of the participants reported current use of any psychiatric medication. 48.4% reported use of an antidepressant and 13% reported use of an antipsychotic. The use of antidepressants remained stable between 1997 and 2009 but the rate of atypical antipsychotic use doubled over this time period. These findings are concerning because antidepressants and atypical antipsychotics have not been shown to be effective in anorexia nervosa and may have significant negative impact on the bone health of this population. Longer-term studies are necessary to evaluate the effectiveness and benefits of these medications before their widespread use continues.
Wednesday, May 22, 2013
Bone Density and Major Depression in Adolescents
For over a decade, Dr. David Herzog, Emeritus
Professor of Psychiatry at Harvard Medical School, has collaborated with the Neuroendocrine Unit at Massachusetts General Hospital (MGH) to learn
more about the impact of anorexia nervosa on bone formation during
adolescence. Now the team is also
examining bone mass in teenagers diagnosed with major depressive disorder.
Major depression is common in adolescents. Among school-aged children, the prevalence is 2%-3% and increases to 4% to 8% among teenagers. Adolescence is also a key period of bone growth. Over 90% of a person’s bone mass has developed by age 18.
Dr. Herzog and his team of scientists in the MGH Neuroendocrine Unit recruited 65 adolescents between the ages of 12 and 18. 32 participants were boys (16 with major depressive disorder and 16 healthy controls) and 33 were girls (17 with major depressive disorder and 16 controls). Dual energy x-ray absorptiometry (DXA) was used to measure participants’ bone density of the lumbar spine and hip, and blood tests were drawn to determine levels of estradiol (the major form of estrogen), testosterone, Vitamin D, and bone turnover markers (biochemical markers of either bone formation or bone resorption).
The study found that boys with major depressive disorder had a significantly lower bone mineral density compared with healthy controls after adjusting for body mass index. This significant finding was maintained after also adjusting for lean mass and bone age. In contrast, bone mineral density in girls with major depression did not differ from controls. It is important for clinicians caring for adolescents, especially boys with depression to be of aware of these findings and the potential for increased risk of fracture. This was the first time the relationship between bone density and depression in adolescent boys has been studied, and further research will shed more light on the topic.
Major depression is common in adolescents. Among school-aged children, the prevalence is 2%-3% and increases to 4% to 8% among teenagers. Adolescence is also a key period of bone growth. Over 90% of a person’s bone mass has developed by age 18.
Dr. Herzog and his team of scientists in the MGH Neuroendocrine Unit recruited 65 adolescents between the ages of 12 and 18. 32 participants were boys (16 with major depressive disorder and 16 healthy controls) and 33 were girls (17 with major depressive disorder and 16 controls). Dual energy x-ray absorptiometry (DXA) was used to measure participants’ bone density of the lumbar spine and hip, and blood tests were drawn to determine levels of estradiol (the major form of estrogen), testosterone, Vitamin D, and bone turnover markers (biochemical markers of either bone formation or bone resorption).
The study found that boys with major depressive disorder had a significantly lower bone mineral density compared with healthy controls after adjusting for body mass index. This significant finding was maintained after also adjusting for lean mass and bone age. In contrast, bone mineral density in girls with major depression did not differ from controls. It is important for clinicians caring for adolescents, especially boys with depression to be of aware of these findings and the potential for increased risk of fracture. This was the first time the relationship between bone density and depression in adolescent boys has been studied, and further research will shed more light on the topic.
Friday, May 17, 2013
Postdoctoral Fellowship Program
Throughout
his career, Dr. David Herzog – Emeritus Professor of Psychiatry at Harvard
Medical School – has endeavored to improve the lives of individuals with eating
disorders. Dr. Herzog was the first
Endowed Professor of Psychiatry in the Field of Eating Disorders at Harvard
Medical School. He founded and directed
the Harvard Eating Disorders Center, which later became the Harris Center for
Education and Advocacy in Eating Disorders at Massachusetts General Hospital
(MGH).
Dr. Herzog
has been deeply committed to helping young scientists embark on careers in
eating disorders. He established the Matina S. Horner, Ph.D. Research Fellowship in 1997 for college and graduate
students. Beginning in 2007 – as part of
his work for the Harris Center at MGH – he also hosted a Postdoctoral
Fellowship to train professionals in the specialized treatment of individuals
with eating disorders.
The Postdoctoral
Fellowship offered early-career investigators the opportunity to contribute to
and learn from the expertise of the Harris Center staff, MGH, and the eating
disorders field. In addition to conducting innovative research, Harris Center
Postdoctoral Fellows treated individuals with eating disorders under Dr.
Herzog’s supervision.
As part of
their training, the fellows attended the MGH Department of Psychiatry's Weekly
Grand Rounds and played an active role in the meetings of the New England Eating Disorders Research Collaborative, a group of over
25 clinicians and scientists in the greater New England area who come together
to share ideas, highlight recent advances in the field, and discuss future
directions in research. Postdoctoral fellows also had the opportunity to
participate in MGH and Harvard Medical School training sessions, such as a
weekly Psychiatric Genetics Seminar and a cognitive behavioral therapy course.
The Harris
Center's first Postdoctoral Fellow (2007-2008) was Kamryn T. Eddy, Ph.D., an exceptional researcher
and clinician. As a Postdoctoral Fellow, Dr. Eddy carried a full clinical
caseload and contributed significantly to the Harris Center's research,
particularly through her work in the areas of the classification of eating
disorders and the treatment of children and adolescents. During her Fellowship
she received two awards for her eating disorders research—the Livingston Award
(from Harvard Medical School) and the Clinical Research Day Psychiatry Award
(from MGH).
At the completion of her Postdoctoral Fellowship, Dr. Eddy continued under Dr. Herzog’s mentorship. She is now an Assistant Professor of Psychiatry at Harvard Medical School and a staff psychologist at MGH.
At the completion of her Postdoctoral Fellowship, Dr. Eddy continued under Dr. Herzog’s mentorship. She is now an Assistant Professor of Psychiatry at Harvard Medical School and a staff psychologist at MGH.
Wednesday, May 15, 2013
Matina S. Horner, Ph.D. Fellowship
Dr. David Herzog, Emeritus Professor of Psychiatry at Harvard Medical School, is an internationally recognized eating disorders expert. He is board certified in pediatrics, child and adolescent psychiatry and general psychiatry and has treated over 3,000 women with anorexia nervosa, bulimia nervosa, and associated diagnoses. Dr. David Herzog was the first Endowed Professor of Psychiatry in the Field of Eating Disorders at Harvard Medical School. He founded and directed the Harris Center for Education and Advocacy in Eating Disorders at Massachusetts General Hospital and, prior to that, the Harvard Eating Disorders Center.
One of Dr. Herzog’s priorities has been to educate new leaders in the field of eating disorders. In 1997, as part of his work for the Harvard Eating Disorders Center, he established a summer fellowship program, which offered undergraduate and graduate students the opportunity for mentorship and supervision as they conducted independent research projects. Dr. Herzog named the fellowship for former Radclife College President Matina S. Horner, Ph.D. in honor of her commitment to the development of women, to the advancement of science, and to the field of health care.
The Matina Horner fellows' eating disorder research projects have covered a wide range of topics, from prevention, to cross-cultural dimensions, to personality and biological factors. Many trainees have contined their independent projects after their fellowships have ended, resulting in published papers. A number of fellows, including S. Bryn Austin, ScD, have achieved academic positions in universities across the nation.
The Matina Horner Fellowship -- the first of its kind -- has now enjoyed 16 years of progress and sponsored 47 young scientists.
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