[Eating disorders in children and adolescents].

Eating disorders in early childhood increase the risk of anorexia or bulimia nervosa in adolescents. In the case of babies feeding disorders and pica are differentiated. Eating disorders in pre-school and primary school age are common.

Does obesity surgery improve psychosocial functioning? A systematic review.

Objective: The objective of this study is to present a review of the psychosocial outcome of bariatric surgery with special consideration of psychiatric comorbidity, psychopathology, psychosocial functioning, econometric data, and general quality of life (QoL).

Purpose: A review of all (non-) controlled trials of the last two decades both with a retrospective and prospective design and a follow-up period of at least 1 y.

Research Methods And Procedures: The relevant literature was identified by a search of computerized databases.

Melanocortin-4 receptor gene: case-control study and transmission disequilibrium test confirm that functionally relevant mutations are compatible with a major gene effect for extreme obesity.

We initially performed a mutation screen of the coding region of the MC4R in 808 extremely obese children and adolescents and 327 underweight or normal-weight controls allowing for a case-control study. A total of 16 different missense, nonsense, and frameshift mutations were found in the obese study group; five of these have not been observed previously. In vitro assays revealed that nine [the haplotype (Y35X; D37V) was counted as one mutation] of the 16 mutations led to impaired cAMP responses, compared with wild-type receptor constructs.

Perspectives: molecular genetic research in human obesity.

Within the past decade the molecular basis of single forms of monogenic obesity has been elucidated. With the exception of functionally relevant mutations in the melanocortin-4 receptor gene, which occur in approximately 2-4% of extremely obese individuals, all other currently known monogenic forms are rare and additionally associated with distinct endocrinological abnormalities. A large number of association studies have been performed in 'normal' obesity.

[Formal genetic findings in attention-deficit/hyperactivity-disorder].

Twin, family and adoption studies have led to a solid understanding of the contribution of both genetic and environmental factors to the development of attention deficit/hyperactivity disorder (ADHD). We review recent studies under consideration of both methodological aspects and relevant findings. Heritability estimates in the range of 0.

The effect of therapeutically induced weight gain on plasma leptin levels in patients with anorexia nervosa.

Previously it was shown that hyperleptinemia ensues from the therapeutically induced weight gain in patients with anorexia nervosa (AN). However, not all studies have been able to confirm this finding. To further investigate leptin secretion during weight gain in AN and potential functional implications serum leptin levels, body mass index (BMI),% body fat, fT3, fT4 and TSH of 18 adolescent AN patients (BMI at admission: 14.

Hyperactivity in patients with anorexia nervosa and in semistarved rats: evidence for a pivotal role of hypoleptinemia.

Patients with anorexia nervosa (AN) often show normal to elevated physical activity levels despite severe weight loss and emaciation. This is seemingly in contrast to the loss of energy and fatigue characteristic of other starvation states associated with weight loss. Despite the fact that historical accounts and clinical case studies of AN have regularly commented on the elevated activity levels, the behavior has become only recently the subject of systematic study.

Lower serum leptin levels in female students of the nutritional sciences with eating disorders.

Background: Evidence has accumulated that in both acutely ill and recovered patients with either anorexia or bulimia nervosa circulating leptin levels (LL) are lower than in controls matched for body mass index (BMI; kg/m(2)). It is unknown if these lower leptin levels represent a state or trait marker.

Aim Of The Study: We aimed to confirm the lowered leptin levels in eating disordered females and to identify underlying mechanisms.

Confidence intervals for genotype relative risks and allele frequencies from the case parent trio design for candidate-gene studies.

Objectives: Confidence intervals for genotype relative risks, for allele frequencies and for the attributable risk in the case parent trio design for candidate-gene studies are proposed which can be easily calculated from the observed familial genotype frequencies.

Methods: Likelihood theory and the delta method were used to derive point estimates and confidence internals. We used Monte Carlo simulations to show the validity of the formulae for a variety of given modes of inheritance and allele frequencies and illustrated their usefulness by applying them to real data.

No evidence for involvement of the promoter polymorphism -866 G/A of the UCP2 gene in childhood-onset obesity in humans.

Recently, an association between obesity and the G-allele of the - 866 G/A polymorphism in the promoter region of uncoupling protein-2 gene (UCP2) was reported. Both allele frequencies and genotype distributions for this polymorphism differed between obese individuals and never-obese controls. We attempted to confirm this finding.

HLA-DRB genotyping in Gilles de la Tourette patients and their parents.

Gilles de la Tourette syndrome (GTS) is a common neuropsychiatric disorder of unknown cause. There is, however, growing evidence that both autoimmune and genetic factors are involved in the pathogenesis of GTS. In classical autoimmune disorders such as diabetes mellitus or multiple sclerosis, genetic susceptibility is at least in part conferred by human leucocyte antigen (HLA-) subtypes, in particular by distinct HLA-DRB alleles.

Reproductive function during weight gain in anorexia nervosa. Leptin represents a metabolic gate to gonadotropin secretion.

The adipocyte hormone leptin plays an important part in the reproductive function and in energy homeostasis. Only single studies have addressed the relationship between leptin and the hypothalamus-pituitary-gonadal axis (HPG) in anorexia nervosa (AN). In the present study 18 female adolescents with AN were investigated during weight gain.

A novel nonsense mutation in the melanocortin-4 receptor associated with obesity in a Spanish population.

Background: In recent years, several groups have reported dominant inheritance of obesity conferred by missense, nonsense and frameshift mutations in the melanocortin 4 receptor gene (MC4R). Hence, MC4R is involved in the most common monogenic form of human obesity described so far.

Objectives: In this context, we screened a Spanish population, composed of obese subjects and normal weight controls, for mutations in the MC4-R by single-strand conformational polymorphism (SSCP).

Genome scan for childhood and adolescent obesity in German families.

Objective: Several genome scans have been performed for adult obesity. Because single formal genetic studies suggest a higher heritability of body weight in adolescence and because genes that influence body weight in adulthood might not be the same as those that are relevant in childhood and adolescence, we performed a whole genome scan.

Methods: The genome scan was based on 89 families with 2 or more obese children (sample 1).

Secular trends in body mass index measurements in preschool children from the City of Aachen, Germany.

Unlabelled: On account of the recent increases in prevalence of childhood obesity in Western countries, the present study tried to verify a secular trend for increasing body mass index (BMI; kg/m(2)) in preschool children in Aachen, Germany. The total sample was based on weight and height data for all 99,500 children of German nationality before enrollment in school in the City of Aachen from 1968-1999. For each year, 10% of the boys and girls respectively, were randomly selected for the analyses.

Spectrum of binge eating symptomatology in patients treated with clozapine and olanzapine.

The authors explored the binge eating symptomatology in 74 patients receiving clozapine (N = 57) or olanzapine (N = 17), and compared body mass index (BMI, kg/m(2)) and weight gain in patients with and without binge eating symptomatology. Subjects who screened positively for binge eating were interviewed using a modified version of the Questionnaire on Eating and Weight Patterns (QEWP). Current BMIs were assessed cross-sectionally, BMIs at initiation of clozapine/olanzapine treatment retrospectively.

5-HT2A promoter polymorphism -1438G/A in children and adolescents with obsessive-compulsive disorders.

Positive association between obsessive compulsive disorder (OCD) and the A-allele of the 5-HT(2A)-receptor promoter polymorphism -1438G/A has recently been reported in adults. We performed an association analysis of this polymorphism in 55 children and adolescents with OCD and in 223 controls consisting of unrelated students. We detected statistically significant differences in genotype (P < 0.

Circulating soluble leptin receptor and free leptin index during childhood, puberty, and adolescence.

Leptin is bound in human blood by a high affinity binding protein, which appears to be identical with the soluble leptin receptor (sOB-R). Using a ligand-mediated immunofunctional assay for the determination of serum sOB-R, we investigated its course during childhood, puberty, and adolescence in a large cohort of 581 healthy children and adolescents and a small group of 13 patients with anorexia nervosa. In the first years of life, sOB-R is detectable in remarkably high concentrations.

[Pharmacological agents for treatment of paraphilias and hypersexual disorders].

We review the indications, modes of action, effectiveness, side effects, legal and ethical aspects of pharmacological agents which reduce sexual desire. It needs to be emphasized that these agents - regardless of their indication - should never be used without concomitant psychotherapy. Nevertheless, in this review we focus on pharmacotherapy, because it can be an important part of the therapeutic procedure and appropriate knowledge is required.

Genetic predisposition to obesity in bulimia nervosa: a mutation screen of the melanocortin-4 receptor gene.

Obesity has been identified as a risk factor for the development of bulimia nervosa (BN). Accordingly, we hypothesize that genotypes predisposing to obesity can be detected in patients with this eating disorder. In order to investigate this hypothesis we screened the melanocortin-4 receptor gene (MC4R) for mutations using single strand conformation analysis in 81 female inpatients treated for BN.

No evidence for involvement of the calpain-10 gene 'high-risk' haplotype combination for non-insulin-dependent diabetes mellitus in early onset obesity.

In light of evidence of linkage of obesity to chromosome 2q31-q37, we hypothesized that the calpain-10 gene 'high-risk' haplotype combination for non-insulin-dependent diabetes mellitus (NIDDM) is involved in early onset obesity. We screened the NIDDM 'high-risk'-haplotype combination formed by the alleles 112 and 121 of the polymorphisms UCSNP-43, -19, and -63 in 166 families consisting of an extremely obese child or adolescent (mean BMI percentile: 99.3+/-1.