Anorexia nervosa is a chronic and severe psychiatric disorder, which occurs 10-20 times more often in women. It is estimated to occur in about 0.5-1% of adolescent girls, it is characterized by a profound disturbance of body image and a relentless pursuit of thinness, and has a range of mortality between 5-18%. Biological factors, like genetic background, neurotransmitter and neuroendocrine systems, social factors, like society’s emphasis on thinness, and psychological factors, like personality traits and ego defense mechanisms, contribute to the pathogenesis of anorexia nervosa. Abnormalities of both 5HT neurotransmission and ΗΡΑ axis activity have been found in disorders like depression, Obsessive Compulsine Disorder (OCD), and eating disorders, but abnormal 5HT neurotransmission seems to be the key factor in anorexia nervosa. Serotonin has been also found to be implicated in the pathogenesis of depressive and obsessive-compulsive symptoms which are common features in anorexia nervosa. Some resent genetic studies have reported positive association between the -1438/A allele of the -1438A/G 5HT-2A-promoter receptor gene polymorphism and anorexia nervosa, but some others have failed to replicate this finding. Tryptophan hydroxylase gene, serotonin transporter gene, dopamine type 1-4 receptor genes, noradrenergic a-3 receptor gene, CRH gene, and Ob gene, provide a hopeful area for future genetic research in patients suffering from anorexia nervosa.

Orestis Giotakos

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