The Weekly Mind Reader: Ghrelin, Anxiety, and Disordered Eating

The discovery of the hormone ghrelin in 1999 revolutionized the science of appetite, especially as it relates to disordered eating patterns. More recently, it’s been implicated in the regulation of anxiety. 

Ghrelin, Anxiety, and ARFID

A new study in The Journal of Clinical Psychiatry neatly put these two theories together by examining ghrelin’s relationship to anxiety in people with avoidant/restrictive food intake disorder, or ARFID.

The Harvard Medical School-led trial recruited 80 young participants who met the full or subthreshold for ARFID. Subjects were screened with a variety of assessments to determine their anxiety levels. They also had their blood drawn to measure their ghrelin levels. After three months, the scientists repeated all tests for comparison.

Overall, lower levels of ghrelin were associated with higher levels of anxiety, particularly in those with ARFID. There was a moderate but significant correlation for all measures of anxiety. Even after taking into account body mass index (BMI) and other factors, the link between ghrelin levels and anxiety remained significant for all 69 subjects in the group that met the full threshold criteria for ARFID. 

In a randomly selected group of participants, ghrelin levels predicted anxiety and obsessive-compulsive disorders with 96 percent accuracy. A diagnosis of either depressive and bipolar disorders accurately correlated with hormone levels 94 percent of the time. For all other categories of mental health diagnoses in the group, the association was 100 percent accurate.

The reason for the inverse relationship? The authors aren’t sure. It could be that a smaller release of ghrelin led to higher anxiety in individuals with ARFID. Or the opposite: ARFID might have caused a drop in ghrelin, which then turned up the dial on anxiety.

Whichever theory is correct, the authors said the discovery could prove useful.

“The confluence of lower ghrelin among individuals with ARFID whose anxiety is high raises the intriguing possibility that interventions targeting ghrelin pathways could be especially beneficial to this group,” they wrote.

In Other Psychiatry and Neurology News This Week 

• A study evaluated how implementation of a novel assessment tool called the Abbreviated SCS Checklist (A-SCS-C) into the electronic medical records can influence decision making in the emergency department.
• The case of a man who developed severe multisystem organ failure due to hydrocarbon toxicity after huffing on compressed air canisters.
• This Rounds Report offers a thoughtful evaluation of why, when, and how to use physical restraints in the emergency department. 
• An interesting write up of a Lupus patient with a rare presentation of mania.  
• Two new drug approvals: A promising new Alzheimer’s drug and a long acting injectable that reduces relapse in schizophrenia by 80 percent. 

Tweet of the Week

May is mental health awareness month. This tweet serves as a great reminder to treat people with empathy. You never know what someone is going through. We should also note, Dani Donovan will be the keynote speaker at CME Institute’s Live Meeting: Emerging Perspectives in Psychiatry, June 24 in New York City, sharing her personal perspective on ADHD and patient advocacy. 

“You need to try harder.”
“Don’t be lazy.”
“Nobody likes doing that stuff.”
“Just make a plan & stick to it.”
“Set a reminder in your phone.”
“It’s not that difficult. Grow up.”

Those with #ADHD know how it feels to struggle with basic habits that seem “easy” to other people 😞 pic.twitter.com/Xv3asQv1C9

— Dani Donovan 🎨 ADHD Comics (@danidonovan) April 30, 2023

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Live CME Meeting: Emerging Perspectives in Psychiatry | June 24 in NYC

Tweetorial: Analyzing Two Schizophrenia Case Reports