While it’s welcome news that researchers have found that certain metabolic genes are linked to anorexia nervosa (Anorexia ‘not solely a psychiatric problem’, 16 July), I suggest that Gerome Breen and colleagues have made a conceptual error in suggesting that this means the condition is not psychiatric. Psychiatric conditions are illnesses primarily concerning mental processes and symptoms, but this definition does not imply a psychological cause, and physical symptoms are common in mental illnesses – just think of the palpitations and over-breathing of a panic attack.
All psychiatric conditions are caused by an interaction between a person’s mind and body; specifically their biology (particularly their DNA), psychological makeup and social context. And gene activity itself can be determined by our environment through epigenetics. Biological processes are increasingly apparent in all mental illnesses through technical advances such as functional brain scans and genomic studies. Advances in prevention and treatment will come through greater understanding of how both mind and body interact to cause a mental illness, not by redefining such illnesses as solely physical.
Emeritus professor of psychological medicine, Wolfson Institute of Preventive Medicine, Queen Mary University of London
• Gaby Hinsliff writes that research into anorexia shows substantial genetic causation (Opinion, 17 July) but history shows little record of self-starving behaviour. It was thankfully very rare. The current tragedy of anorexia is of great concern. But it is a quite recent phenomenon. To suggest its causes are rooted in DNA is clearly incorrect. To suggest this to a person suffering anorexia is at best to distract them from what to do to relieve their troubles.
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