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. 2013 May;74(5):e451-7.
doi: 10.4088/JCP.12m08154.

Postprandial oxytocin secretion is associated with severity of anxiety and depressive symptoms in anorexia nervosa

Elizabeth A Lawson  1 , Laura M Holsen, McKale Santin, Rebecca DeSanti, Erinne Meenaghan, Kamryn T Eddy, David B Herzog, Jill M Goldstein, Anne Klibanski
Affiliations

Postprandial oxytocin secretion is associated with severity of anxiety and depressive symptoms in anorexia nervosa

Elizabeth A Lawson et al. J Clin Psychiatry. 2013 May.

Erratum in

Abstract

Objective: Anorexia nervosa, a psychiatric disorder characterized by self-induced starvation, is associated with endocrine dysfunction and comorbid anxiety and depression. Animal data suggest that oxytocin may have anxiolytic and antidepressant effects. We have reported increased postprandial oxytocin levels in women with active anorexia nervosa and decreased levels in weight-recovered women with anorexia nervosa compared to healthy controls. A meal may represent a significant source of stress in patients with disordered eating. We therefore investigated the association between postprandial oxytocin secretion and symptoms of anxiety and depression in anorexia nervosa.

Method: We performed a cross-sectional study of 35 women (13 women with active anorexia nervosa, 9 with weight-recovered anorexia nervosa, and 13 healthy controls). Anorexia nervosa was diagnosed according to DSM-IV-TR criteria. Serum oxytocin and cortisol and plasma leptin levels were measured fasting and 30, 60, and 120 minutes after a standardized mixed meal. The area under the curve (AUC) and, for oxytocin, postprandial nadir and peak levels were determined. Anxiety and depressive symptoms were assessed using the Spielberger State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory II (BDI-II). The study was conducted from January 2009 to March 2011.

Results: In women with anorexia nervosa, oxytocin AUC and postprandial nadir and peak levels were positively associated with STAI trait and STAI premeal and postmeal state scores. Oxytocin AUC and nadir levels were positively associated with BDI-II scores. After controlling for cortisol AUC, all of the relationships remained significant. After controlling for leptin AUC, most of the relationships remained significant. Oxytocin secretion explained up to 51% of the variance in STAI trait and 24% of the variance in BDI-II scores.

Conclusions: Abnormal postprandial oxytocin secretion in women with anorexia nervosa is associated with increased symptoms of anxiety and depression. This link may represent an adaptive response of oxytocin secretion to food-related symptoms of anxiety and depression.

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Figures

Figure 1
Figure 1. Oxytocin levels fasting and after a mixed meal
Oxytocin levels were high in AN compared to HC at 60 and 120 min after the meal and low in ANWR compared to HC fasting and 30 and 120 min after the meal. Diamonds, AN; triangles, HC; squares, ANWR. *, p<0.05 compared to HC.
Figure 2
Figure 2. Relationship between oxytocin secretion and symptoms of anxiety and depression in AN and ANWR
Oxytocin AUC was significantly associated with (A) STAI trait (r=0.72, p=0.0002) and (B) BDI-II (r=0.44, p=0.043) scores.
Figure 3
Figure 3. Oxytocin secretion in AN and ANWR subjects with and without anxiety and depressive symptoms
Mean oxytocin AUC was high in active and weight-recovered women with (A) anxiety (black) and (B) more than minimal depressive (striped) symptoms compared to those without (white). *, p=0.002 vs. those without symptoms.
See this image and copyright information in PMC

References

    1. Lawson EA, Klibanski A. Endocrine abnormalities in anorexia nervosa. Nat Clin Pract Endocrinol Metab. 2008 Jul;4(7):407–414. - PubMed
    1. Herzog DB, Eddy KT. Psychiatric comorbidity in eating disorders. In: Wonderlich SMJ, de Zwaan M, Steiger H, editors. Annual Review of Eating Disorders. Radcliffe Publishing, Ltd; Oxford, United Kingdom: 2007. pp. 35–50.
    1. Lawson E, Donoho D, Blum J, et al. Decreased nocturnal oxytocin levels in anorexia nervosa are associated with low bone mineral density and fat mass. Journal of Clinical Psychiatry. 2011;72(11):1546–1551. - PMC - PubMed
    1. Lawson EA, Holsen LM, Santin M, et al. Oxytocin secretion is associated with severity of disordered eating psychopathology and insular cortex hypoactivation in anorexia nervosa. J Clin Endocrinol Metab. 2012;97(10):E1898–1908. - PMC - PubMed
    1. Holsen LM, Lawson EA, Blum J, et al. Food Motivation Circuitry Hypoactivation Related to Hedonic and Non-Hedonic Aspects of Hunger and Satiety in Women with Active and Weight-Restored Anorexia Nervosa. Journal of Psychiatry and Neuroscience. 2012;37(3) - PMC - PubMed

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