Beate Herpertz-Dahlmann

Beate Herpertz-Dahlmann
RWTH Aachen University · Department of Psychiatry, Psychotherapy and Psychosomatics

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Publications (553)
Article
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Anorexia Nervosa (AN) has the highest mortality of all psychiatric disorders. Patients who experience the onset of AN in their teens suffer on average 10 years from an eating or other mental disorder. Recently many clinicians in the US and Europe have addressed the inadequacy of treatment for this disabling disease which – at least in adult patient...
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Objective: The current study explored the role of maternal depressive symptoms in the intergenerational transmission of childhood maltreatment and developmental psychopathology. Based on the sensitive window hypothesis, the effects of earlier versus later maternal depression symptoms on child development were analysed. Method: Ninety-nine mother...
Article
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IntroductionAnorexia nervosa (AN) is an often chronic and debilitating psychiatric disease whose etiology is not completely understood. Recently, a potential role of inflammation has emerged in other psychiatric diseases, such as depression, PTSD and schizophrenia. The first results in adults with AN seemed to confirm a low-grade proinflammatory st...
Chapter
In diesem Kapitel werden die wesentlichen Bausteine der Therapie von Essstörungen, insbesondere der Anorexia nervosa, beschrieben. Auf die Behandlung der vermeidend-restriktiven Essstörungen wird an anderer Stelle eingegangen (Kap.). Die Leserin und der Leser werden über die somatische Behandlung und Ernährungstherapie, wesentliche Prinzipien der i...
Chapter
In Deutschland und anderen europäischen Ländern haben die stationären Behandlungen bei Kindern und Jugendlichen, aber auch Erwachsenen mit Anorexia nervosa (AN) kontinuierlich zugenommen (Stat. Bundesamt 2019; z. B. Cruz et al. 2018), obwohl große Zweifel bestehen, dass die stationäre Therapie anderen Behandlungsformen überlegen ist. In einer mehr...
Chapter
In diesem Kapitel wird auf Definition, Epidemiologie, Symptomatologie und Komorbidität der kindlichen und adoleszenten Anorexia nervosa eingegangen. Bezüglich der Klassifikation werden die Schwierigkeiten, die durch die alterstypische Symptomatik bedingt sind, erläutert und die Problematik des Gewichtsschwellenwertes diskutiert. Erste Symptome, die...
Article
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Background Anorexia nervosa (AN) is a severe psychiatric disease that often takes a chronic course due to insufficient treatment options. Emerging evidence on the gut-brain axis offers the opportunity to find innovative treatments for patients with psychiatric disorders. The gut microbiome of patients with AN shows profound alterations that do not...
Article
Caring for a child with anorexia nervosa (AN) puts a strain on many parents. At the same time, actively involving the parents in treatment to increase their skills tomanage the disorder is important, as it seems to improve the child's prognosis. Home treatment requires the parents to be particularly involved. The aim of this study was to assess par...
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Background The COVID-19 pandemic, associated with confinement and social isolation, seems to have impacted the course of many mental disorders in children and adolescents. An increase in hospital admission rates for juvenile anorexia nervosa (AN) has been documented in many regions of the world. However, data from Europe are scarce. Methods We ask...
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Genetic factors are relevant for both eating disorders and body weight regulation. A recent genome-wide association study (GWAS) for anorexia nervosa (AN) detected eight genome-wide significant chromosomal loci. One of these loci, rs10747478, was also genome-wide and significantly associated with body mass index (BMI). The nearest coding gene is th...
Article
Introduction: Theory of mind (ToM) is important for social interactions and typical development and has been found to be impaired in patients with anorexia nervosa (AN) and bulimia nervosa (BN). Hypoactivation in frontotemporal brain regions seems to be the underlying neural mechanism in AN while whole-brain analyses in BN are lacking. Methods:...
Preprint
Theoretical and empirical accounts suggest that adolescence is associated with heightened reward learning and impulsivity. Experimental tasks and computational models that can dissociate reward learning from the tendency to initiate actions impulsively (action initiation bias) are thus critical to characterise the mechanisms that drive developmenta...
Article
ZUSAMMENFASSUNG Die Anorexia nervosa (AN) ist die psychische Erkrankung mit der höchsten Mortalität. Individuen, die im Jugendalter erkranken, leiden durchschnittlich über 10 Jahre an dieser Störung. Obwohl die klinische Erfahrung und internationale sowie nationale Studien auf einen unzureichenden Heilungserfolg hinweisen, wird in Deutschland meist...
Article
Background The pattern of structural brain abnormalities in anorexia nervosa (AN) is still not well understood. While several studies report substantial deficits in grey matter volume and cortical thickness in acutely underweight patients, others find no differences, or even increases in patients compared with healthy controls. Recent weight regain...
Article
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Due to modern technological innovations, aggressive behaviors have expanded into the cyberspace, creating a new matter of public concern: cyberbullying. Antisocial and aggressive behaviors, including bullying are characteristic for children and adolescents diagnosed with conduct disorder (CD), raising the question whether these youths are highly in...
Article
Essstörungen betreffen immer häufiger auch Kinder und Jugendliche. Die Adoleszenz ist eine kritische Zeit für die Entwicklung von gestörtem Essverhalten und verzerrter Körperwahrnehmung. Gleichzeitig sind Essstörungen in der Adoleszenz oftmals mit schwerwiegenden Folgen im Erwachsenenalter assoziiert. Dieser Beitrag fasst die Ergebnisse der BELLA-K...
Article
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Background Body mass index (BMI) at hospital admission in patients with anorexia nervosa (AN) represents a prognostic marker for mortality, chronicity and future body weight. The current study focused on the associations between BMI standard deviation score (BMI-SDS) at admission and reasons for seeking inpatient treatment. Further interest was giv...
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Background Reduced birthweight is associated with adverse physical and mental health outcomes later in life. Children of adolescent mothers are at higher risk for reduced birthweight. The current study aimed to identify the key risk factors affecting birthweight in a well-characterized sample of adolescent mothers to inform preventive public health...
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Objective Knowledge on gut–brain interaction might help to develop new therapies for patients with anorexia nervosa (AN), as severe starvation-induced changes of the microbiome (MI) do not normalise with weight gain. We examine the effects of probiotics supplementation on the gut MI in patients with AN. Method This is a study protocol for a two-ce...
Article
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Anorexia nervosa (AN) is a severe psychiatric disorder characterized by energy restriction, low body weight, a fear of gaining weight and often excessive physical activity. Anxiety disorders appear to constitute a major risk factor for developing AN and are the most frequent comorbidity. Here, the influence of anxiety‐like behavior prior to food re...
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Zusammenfassung Hintergrund und Ziel Die im Rahmen der COVID-19-Pandemie erlassenen Maßnahmen zum Infektionsschutz führten zu tiefgreifenden Einschränkungen und Veränderungen im sozialen, (vor-)schulischen, familiären und Freizeitbereich. Die vorliegende Studie untersucht das Ausmaß an psychischer Belastung von Kindern, Jugendlichen und ihren Fami...
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Background: The previous and current studies highlight the psychological distress caused by coronavirus disease 2019 (COVID-19)-associated restrictions among the general population, especially among children and adolescents; however, few studies have examined children and adolescents with a mental disorder. The current study aimed to explore whethe...
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Objective Conduct disorder (CD) and attention-deficit/hyperactivity disorder (ADHD) are reported to co-occur in about 30-50% of affected individuals. Research suggests that poor reinforcement-based decision-making may contribute to impaired social functioning in both youths with CD and ADHD. Considering its frequent co-occurrence this raises the qu...
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Introduction: Anorexia nervosa (AN) is a serious mental disorder that typically manifests in adolescence. Motivation to change is an important predictor for treatment outcome in adolescent AN, even though its development over the often long therapeutic process, with transitions between treatment settings, has not yet been studied. In this pilot stu...
Article
Background Genetics and biology may influence the age at onset of anorexia nervosa (AN). The aims of this study were to determine whether common genetic variation contributes to AN age at onset and to investigate the genetic associations between age at onset of AN and age at menarche. Methods A secondary analysis of the Psychiatric Genomics Consor...
Article
Background: Brain-derived neurotrophic factor (BDNF) influences brain plasticity and feeding behaviour, and it has been linked to anorexia nervosa in numerous studies. Findings in mostly adult patients point to reduced serum BDNF levels in the acute stage of anorexia nervosa and rising levels with weight recovery. However, it is unclear whether th...
Article
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In April 2020, the European Society for Child and Adolescent Psychiatry (ESCAP) Research Academy and the ESCAP Board launched the first questionnaire of the CovCAP longitudinal survey to estimate the impact of COVID-19 on child and adolescent psychiatry (CAP) services in Europe. In this brief report, we present the main findings from the second que...
Article
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(1) Background: Evidence has accumulated that patients with anorexia nervosa (AN) are at higher risk for vitamin D deficiency than healthy controls. In epidemiologic studies, low 25(OH) vitamin D (25(OH)D) levels were associated with depression. This study analyzed the relationship between 25(OH)D serum levels in adolescent patients and AN and depr...
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Both DSM-5 and ICD-11 have provided weight cut-offs and severity specifiers for the diagnosis of anorexia nervosa (AN) in childhood, adolescence and adulthood. The aims of the current study focusing on inpatients aged < 19 years were to assess (1) the relationship between age and body mass index (BMI; kg/m2), BMI-centiles, BMI-standard deviation sc...
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Background: Conduct disorder (CD) rarely occurs alone but is typically accompanied by comorbid psychiatric disorders, which complicates the clinical presentation and treatment of affected youths. The aim of this study was to investigate sex differences in comorbidity patterns in CD and to systematically explore the ‘gender paradox’ and ‘delayed-ons...
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Objective It was the aim of this pilot study to apply a novel eating disorder (ED)‐specific home treatment (HoT) to adolescents with anorexia nervosa (AN) and to investigate its feasibility, effects and safety. Method Twenty‐two patients consecutively admitted to the hospital and fulfilling DSM‐5 criteria for typical or atypical AN received HoT af...
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Conduct Disorder (CD) is characterized by severe aggressive and antisocial behavior. The stress hormone system has frequently been investigated as a neurobiological correlate of CD, while other interacting neuroendocrine biomarkers of sex hormone or neuropeptide systems have rarely been studied, especially in females. We examined multiple basal neu...
Article
Anorexia nervosa (AN) is one of the most common chronic disorders in adolescence with still high mortality rates. Knowledge on gut-brain interaction might help to develop new treatments, as severe starvation-induced changes of the microbiome in AN-patients have been demonstrated, which do not alleviate with weight gain. In our own pilot study alpha...
Article
Objective: There are no generally accepted definitions or markers of treatment nonresponse in eating disorders (EDs). The aim of this paper was to examine how the duration of illness and other potential prognostic markers impacted on nonresponse and drop-out from treatment across different EDs subtypes. Methods: A total sample of 1199 consecutiv...
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Background Despite the increasing interest in cardiac autonomic nervous activity, the normal development is not fully understood. The main aim was to determine the maturation of different cardiac sympathetic‐(SNS) and parasympathetic nervous system (PNS) activity parameters in healthy patients aged 0.5 to 20 years. A second aim was to determine pot...
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Objective Anorexia nervosa (AN) often has its onset in childhood or adolescence. However, there is insufficient knowledge regarding access to and utilisation of age‐specific clinical diagnostics and treatment. Methods A literature review covering the last 10 years was conducted to provide a narrative review of the current state of research on the...
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Cognitive flexibility helps us to navigate through our ever-changing environment and has often been examined by reversal learning paradigms. Performance in reversal learning can be modeled using computational modeling which allows for the specification of biologically plausible models to infer psychological mechanisms. Although such models are incr...
Article
Anorexia nervosa (AN) is an eating disorder that leads to brain volume reduction and is difficult to treat since the underlying pathophysiology is poorly understood. The human gut microbiota is known to be involved in host metabolism, appetite- and bodyweight regulation, gut permeability, inflammation and gut-brain interactions. In this study, we u...
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Background: At the group level, youths with conduct disorder (CD) show deficient emotion processing across various tasks compared to typically developing controls (TDC). But little is known about neuropsychological subgroups within the CD population, the clinical correlates of emotion processing deficits [for instance, with regard to the presence o...
Article
Zusammenfassung Adoleszente Mütter und ihre Kinder stellen eine Hochrisikogruppe für ungünstige Entwicklungsverläufe dar. Frühe Gesundheits- und Förderangebote sollen belastete Mutter-Kind-Dyaden unterstützen. Das Ziel der vorliegenden Arbeit ist die Untersuchung und der Vergleich der Inanspruchnahme dieser Angebote durch adoleszente Mutter-Kind-Dy...
Article
Zusammenfassung. Die Umstellung auf die 11. Revision der Internationalen Klassifikation der Krankheiten und verwandter Gesundheitsprobleme (ICD-11) bedingt wesentliche Neuerungen bezüglich i) Zusammenführung der Fütter- und Essstörungen zu einer übergeordneten Kategorie, ii) Gruppierung der Störungsbilder nach ihrer Psychopathologie im Sinne eines...
Article
Attention deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) represent two of the most common neurobehavioral disorders of childhood. This chapter summarizes the diagnostic criteria and epidemiological data as well as data on the symptomatology and course of antisocial behavior. It describes the role of ADHD in the etiology and pathoge...
Article
In the current Diagnostic and Statistical Manual of Mental Disorders version, there are four subtypes of attention deficit/hyperactivity disorder (ADHD): first, a predominantly inattentive type; second, a predominantly hyperactive‐impulsive type; third, a combined type; and fourth, a newly defined inattentive type. Children with ADHD are at high ri...
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Reduced responsiveness to emotions is hypothesized to contribute to the development of conduct disorder (CD) in children and adolescents. Accordingly, blunted psychophysiological responses to emotions have been observed in boys with CD, but this has never been tested in girls. Therefore, this study compared psychophysiological responses to sadness...
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Anorexia nervosa (AN) can probably be regarded as a “model” for studying the interaction of nutrition with the gut–brain axis, which has drawn increased attention from researchers and clinicians alike. The gut microbiota influences somatic effects, such as energy extraction from food and body weight gain, as well as appetite, gut permeability, infl...
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Brain-to-brain synchrony has been proposed as an important mechanism underlying social interaction. While first findings indicate that it may be modulated in children with ASD, no study to date has investigated the influence of different interaction partners and task characteristics. Using functional near-infrared spectroscopy hyperscanning, we ass...
Article
Zusammenfassung. Die Klassifikation nach ICD-11 weist deutliche Veränderungen gegenüber der ICD-10 auf. Wesentliche Neuerungen bestehen im Wegfall des Begriffes der Konversionsstörung als auch jedweder Bewertung des Verhaltens. Eine hohe Bedeutung kommt den spezifischen funktionellen neurologischen Störungen zu, die an erster Stelle in dieser Kateg...
Article
Children of adolescent mothers are a high-risk group for negative child development. Previous findings suggest that early interventions may enhance child development by improving mother–child interaction. The purpose of the current study was to evaluate a mother–child intervention (STEEP-b) program in high-risk adolescent mother–infant dyads ( N =...
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Less is known about the relationship between conduct disorder (CD), callous–unemotional (CU) traits, and positive and negative parenting in youth compared to early childhood. We combined traditional univariate analyses with a novel machine learning classifier (Angle-based Generalized Matrix Learning Vector Quantization) to classify youth ( N = 756;...
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This commentary on serious and enduring anorexia nervosa adopts the position of a developmental psychiatrist. It argues that this perspective illuminates the etiology and course of severe and enduring anorexia nervosa (SE‐AN) and could thus help to develop treatments targeting typical early characteristics of patients with SE‐AN. Based on a detaile...
Article
Fragestellung: Kinder mit Beeinträchtigungen des Sehens (BS) zeigten in einigen Untersuchungen autismusähnliche Verhaltensweisen. Die Anwendung vorhandener diagnostischer Screening-Instrumente für Autismus-Spektrum-Störungen (ASS) ist problematisch, da diese in der Regel ein intaktes Sehvermögen voraussetzen. Ziel dieser explorativen Studie war es,...
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Genome-wide association studies have discovered hundreds of loci associated with complex brain disorders, but it remains unclear in which cell types these loci are active. Here we integrate genome-wide association study results with single-cell transcriptomic data from the entire mouse nervous system to systematically identify cell types underlying...
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Although anger may weaken response inhibition (RI) by allowing outbursts to bypass deliberate processing, it is equally likely that RI deficits precipitate a state of anger (SA). In adolescents, for instance, anger occurs more frequently and often leads to escalating aggressive behaviors. Even though RI is considered a key component in explaining i...
Article
Zusammenfassung. Fragestellung: Ziel der Längsschnittstudie ist es, herauszufinden, welche mütterlichen Faktoren die Auswirkungen adoleszenter Mutterschaft auf die kognitive und sprachliche Entwicklung sowie Verhaltensprobleme bei Kindern im Vorschulalter beeinflussen. Basierend auf dem aktuellen Stand der Literatur wurden mütterliche Feinfühligkei...
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Background: A deficit in empathy has repeatedly been described in individuals with conduct disorder (CD), and in particular in those with callous unemotional traits. Until now, little is known about the neural basis of empathy in children and adolescents with early onset conduct disorder. The aim of this study was to examine neural responses during...
Chapter
Eating and weight disorders frequently persist over time despite extensive therapeutic efforts. Both high dropout and lost-to-follow-up rates observed in randomized controlled trials indicate that many patients are not satisfied by current treatment options. Particularly, obesity-related research has underscored the multitude and complexity of aeti...
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Eating disorders and substance use disorders frequently co‐occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa and problem alcohol use (genetic correlation [rg], twin‐based = 0.23‐0.53). We estimated the genetic correlation...
Article
ZUSAMMENFASSUNG Das menschliche Darm-Mikrobiom ist am Stoffwechsel, der Gewichtsregulierung, der Entwicklung des Immunsystems sowie an der Interaktion zwischen Darm und Gehirn des Wirtes beteiligt. Patientinnen mit Anorexia nervosa (AN) zeigen deutliche Mikrobiomveränderungen, zum Beispiel eine reduzierte Bakterienvielfalt. AN-bezogene Veränderunge...
Chapter
Bei der AN kommt es durch Einschränkung oder unzureichende Steigerung der Energieaufnahme (bei Wachstum/intensivem Sport) zur Enstehung oder Aufrechterhaltung eines Untergewichts. Das Körpergewicht liegt unter dem für Geschlecht, Größe und Alter zu erwartenden Gewicht. Betroffene haben trotz ihres Untergewichts Angst davor, zu dick zu sein und/oder...
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The growing interest in testosterone's effects on men's social behaviors, in particular aggressive, risk-taking, or status maintenance behaviors, is accompanied by a paucity of dose-dependent pharmacokinetic data. Examining the neurophysiological effects of transdermal testosterone typically includes a 4h delay before further brain-behavior measure...
Article
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We aimed to compare the clinical data at first presentation to inpatient treatment of children (<14 years) vs. adolescents (≥14 years) with anorexia nervosa (AN), focusing on duration of illness before hospital admission and body mass index (BMI) at admission and discharge, proven predictors of the outcomes of adolescent AN. Clinical data at first...
Article
Objective: Nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) are common disorders in childhood and are frequently accompanied by comorbid psychiatric disorders. Despite a high association between urinary and fecal incontinence with psychiatric and neurodevelopmental disorders, research on comorbidity between...
Preprint
Full-text available
Eating disorders and substance use disorders frequently co-occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa (BN) and problem alcohol use (genetic correlation [rg], twin-based=0.23-0.53). We estimated the genetic correlati...
Article
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Knowledge of anorexia nervosa (AN) in childhood is scarce. This review gives a state-of-the-art overview on the definition, classification, epidemiology and etiology of this serious disorder. The typical features of childhood AN in comparison to adolescent AN and avoidant restrictive eating disorder (ARFID) are described. Other important issues dis...
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Characterized primarily by a low body-mass index, anorexia nervosa is a complex and serious illness¹, affecting 0.9–4% of women and 0.3% of men2–4, with twin-based heritability estimates of 50–60%⁵. Mortality rates are higher than those in other psychiatric disorders⁶, and outcomes are unacceptably poor⁷. Here we combine data from the Anorexia Nerv...