Project ID NS-MH2024_30

ThemeNS-MH

Co Supervisor 1A Institute of Psychiatry, Psychology & Neuroscience, School of Academic Psychiatry, Department of Psychological MedicineWebsite

Co Supervisor 1B Institute of Psychiatry, Psychology & Neuroscience, School of Academic Psychiatry, Department of Psychological MedicineWebsite

MOlecular, NeuroImaging and Clinical biomarkers for Anorexia nervosa (MONICA)

In many areas of psychiatry (e.g., dementia and psychosis), biomarkers are already in use for diagnostic purposes and as therapeutic decision aids. This is not yet the case in the field of eating disorders even though the scientific evidence for specific genetic, endocrinological, immunological and brain imaging biomarkers is increasing. However, most of these findings have not been implemented into clinical practice; and routinely measured biomarkers are not yet used to allocate specific therapies or therapeutic pathways to patients with anorexia nervosa in an individually tailored way. The figure below illustrates potential connections of molecular, neuroimaging and clinical biomarkers with biological and psychological treatments for anorexia nervosa.

This project consists of four milestones:
– A systematic review of molecular and neuroimaging biomarkers as outcome predictors for the treatment of anorexia nervosa.
– Evaluation of routinely measured laboratory parameters (e.g., liver enzymes, C-reactive protein, and leukocyte count) as predictors of therapy outcome using the Clinical Record Interactive Search (CRIS) database. This database contains laboratory parameters about 3,500 patients with anorexia nervosa.
– An analysis of the therapeutic outcome of patients from the TRIANGLE study (a RCT with n=370 participants); clinical parameters (e.g., BMI and comorbidities) will be examined regarding their predictive value.
– Active involvement in the development of a World Federation of Societies of Biological Psychiatry (WFSBP) consensus statement or guideline on the use of biomarkers in anorexia nervosa.

Through these milestones, the PhD candidate will learn how to summarise and synthesise scientific evidence, how to use a big database, how to evaluate data from clinical trials and how to translate scientific results into practice guidelines.

Representative Publications

Himmerich H, Lewis YD, Conti C, Mutwalli H, Karwautz A, Sjögren JM, Uribe Isaza MM, Tyszkiewicz-Nwafor M, Aigner M, McElroy SL, Treasure J, Kasper S & The WFSBP Task Force on Eating Disorders. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines update 2023 on the pharmacological treatment of eating disorders. World J Biol Psychiatry. 2023. https://doi.org/10.1080/15622975.2023.2179663.

Carr A, Toloza C, Li Z, Nazar BP, Himmerich H. Therapy outcome of day treatment for people with anorexia nervosa before and during the COVID-19 pandemic. Brain Behav. 2022;12:e2604. https://doi.org/10.1002/brb3.2604.

Himmerich H, Hotopf M, Shetty H, Schmidt U, Treasure J, Hayes RD, Stewart R, Chang CK. Psychiatric comorbidity as a risk factor for mortality in people with anorexia nervosa. Eur Arch Psychiatry Clin Neurosci. 2019;269:351-359. https://doi.org/10.1007/s00406-018-0937-8.

Monteleone AM, Cascino G, Salerno L, Schmidt U, Micali N, Cardi V, Treasure J. A network analysis in adolescent anorexia nervosa exploring the connection between both patient and carer reactions and outcome. Eur Eat Disord Rev. 2023;31:65-75. https://doi.org/10.1002/erv.2933.

Treasure J, Hübel C, Himmerich H. The evolving epidemiology and differential etiopathogenesis of eating disorders: implications for prevention and treatment. World Psychiatry. 2022;21:147-148. doi: https://doi.org/10.1002/wps.20935.

Treasure J, Duarte TA, Schmidt U. Eating disorders. Lancet. 2020;395:899-911. https://doi.org/10.1016/S0140-6736(20)30059-3.