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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although eating disorders of the bulimic type have been known for a long time, "bulimia nervosa" as a special and specific type of eating disorder was described only during the last decade. Clinical evidence has shown an increase in bulimic disturbances during the last few years. About 30% of the bulimic disturbances begin between the 14th and 18th year of age. About 50% of patients with bulimia nervosa have been anorexic before. A group of 30 patients with anorexia nervosa and a group of 11 patients with bulimia nervosa were compared by means of the dexamethasone suppression test and two depression scales at the beginning of inpatient treatment, after 8-12 weeks of inpatient treatment and at discharge. Patients with anorexia nervosa revealed significantly higher cortisol levels at the beginning of inpatient treatment as compared with the bulimic group. Cortisol levels were normalized with weight gain. Therapeutic measures in bulimia nervosa comprise medical and psychotherapeutic methods.
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PMID:[Bulimia nervosa in adolescence]. 322 86

Antidepressant therapy has been shown to be efficacious in the treatment of bulimia nervosa, a serious eating disorder that can be associated with substantial morbidity and mortality. Seven antidepressant drugs have been tested in double-blind, placebo-controlled studies. Five of these studies demonstrated strongly positive findings, one a weakly positive finding, and one a negative finding. However, inadequate doses of medication may have been used in the latter two studies. In all of the positive studies, antidepressant agents appeared effective even in bulimic subjects who did not display concomitant depression, indicating that this treatment modality should not be reserved only for depressed bulimic patients. Although not yet tested in double-blind studies, trazodone also appears effective in the treatment of bulimia nervosa. Results from one large open study suggested that trazodone has comparable efficacy to the tricyclic antidepressant agents. Trazodone would be a particularly attractive treatment for bulimia nervosa because of its low anticholinergic side-effects profile; placebo-controlled studies are required, however, before definitive recommendations can be made.
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PMID:Antidepressant medication in the treatment of bulimia nervosa. 332 Nov 25

Bulimia nervosa is a common eating disorder among women. Sociocultural and interpersonal pressures are thought to be highly influential in the development of the syndrome. An association with depression has also been suggested. Recognizing bulimia nervosa is usually difficult, because patients are hesitant to reveal their symptoms. If the condition is diagnosed early in its course, the prognosis is more favorable. Use of tricyclic antidepressants and psychotherapy is the accepted treatment regimen.
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PMID:Bulimia nervosa. Uncovering a secret disorder. 339 60

A combined survey and interview study was conducted to validate a categorical Dieting and Bingeing Severity Scale (DBSS), and to estimate the prevalence of eating disorders in young women. We hypothesized that assignment to the DBSS categories would be confirmed by clinical interviews such that interview-diagnosed eating disorders would be found with increasing frequency and severity at the upper end of the DBSS. Freshmen college women (n = 1367) completed a survey instrument addressing the frequency and severity of dieting, binge-eating, and other behaviors and attitudes related to weight control. Random stratified sampling procedures were used to select a subset of women (n = 306) from each DBSS category for structured clinical interviews for DSM-III-R (SCID). Survey respondents were assigned to one of six mutually exclusive DBSS categories: non-dieters (9% of sample), casual dieters (26%), moderate dieters (23%), intense dieters (21%), dieters at-risk (19%), and probable bulimia nervosa (2%). The DBSS effectively rank-ordered subjects according to the risk of having interview-diagnosed eating disorders. Women in the three most severe DBSS categories were significantly more likely to have current subthreshold and threshold level eating disorders, in particular bulimia nervosa and eating disorder not otherwise specified (EDNOS). The estimated prevalence of current bulimia nervosa was approximately 2% by both survey and interview methods. The prevalence of current EDNOS was 13%, more than six times greater than the prevalence of bulimia nervosa. The DBSS was found to be a reliable and valid measure of dieting and bingeing severity. The survey instrument may be useful in measuring the extent of, and changes in, pathological dieting in community-based samples of young women, and in studying comorbidity of dieting and bingeing severity with other psychiatric conditions including depression and substance use. The DBSS may also be useful in identifying risk factors associated with the onset of eating disorders.
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PMID:The severity of dieting and bingeing behaviors in college women: interview validation of survey data. 747 97

Fifteen women with bulimia nervosa were treated with a 4-month course of combined cognitive-behavioral, nutritional and antidepressant therapy (5 with amineptine and 10 with fluvoxamine). Patients were monitored before and after 1, 2 and 4 months of therapy for body mass index (BMI), for eating disorder symptoms by the Eating Disorder Inventory (EDI) and the Bulimic Investigation Test (BITE), and for depression and anxiety by the Hamilton Rating Scale for Depression and for Anxiety (HRS-D and -A). BITE symptoms and gravity improved significantly and equally in the two groups during the 4 months of therapy. Global EDI scores, depression and anxiety decreased but not significantly. BMI was normal before therapy and did not change during treatment.
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PMID:Combined cognitive-behavioral, psychopharmacological and nutritional therapy in bulimia nervosa. 747 2

Instructions for self-treatment, whether printed, presented via computer or by audiovisual means, are effective in the management of phobias, panic disorder, other anxieties, depression, bulimia nervosa, obesity, alcohol problems, nicotine abuse, myocardial infarction, AIDS, compliance problems and the counseling of patients' relatives. A lasting improvement has been shown for up to 7 years. The mechanisms of effective self-change are discussed.
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PMID:[Help with self-care]. 754 90

The purpose of this study was to compare data from a group of obese subjects with binge eating disorder (BED) with data from a group of normal weight bulimia nervosa (BN) subjects. Subjects were compared using the Eating Disorder Questionnaire (EDQ), the Eating Disorder Inventory (EDI), the Personality Disorders Questionnaire for DSM-III-R (PDQ-R), the Hamilton Anxiety and Depression Rating Scales, and the Beck Depression Inventory. A group of 35 age-matched subjects were selected retrospectively from treatment study subjects. The EDQ findings indicated that members of the BN group desired a lower body mass index, were more afraid of becoming fat, and more uncomfortable with their binge eating behavior than the BED group members. The BED subjects had a younger age of onset of binge eating behavior (14.3) than the BN subjects (19.8), even though both groups started dieting at a similar age (BED = 15.0, BN = 16.2). The EDI results showed BN subjects had more eating and weight-related pathology, with significantly higher scores on five of the eight subscales. On the PDQ-R more BN subjects endorsed Axis II impairment (BN = 69%, BED = 40%). While demonstrating greater eating pathology in the BN group, this study also found significant pathology and distress in BED subjects.
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PMID:An age-matched comparison of subjects with binge eating disorder and bulimia nervosa. 758 15

The aim of this study was to retrospectively identify clinical variables assessed prior to treatment which were predictive of patients' dropping out versus completing a 10 week group cognitive-behavioral treatment program for bulimia nervosa. Following a lengthy initial assessment, 81 women meeting DSM-III-R criteria for bulimia nervosa (BN) were referred to one of twelve 10-week groups of 8 to 12 patients having bulimic symptoms. The dropout rate for those meeting full DSM-III-R criteria for BN was found to be 28.7%. A series of seven discriminant function analyses were performed to determine whether dropouts differed from completers in terms of depression, anxiety, difficulties in trust and relating to others, bulimic symptom severity, family environment, weight history and symptom duration and severity of bulimic cognitions. Of these, only the factor assessing difficulties trusting and relating to others was found to significantly discriminate dropouts from completers. Implications of the findings are discussed in terms of clinical and research relevance in the field of eating disorders.
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PMID:Factors affecting dropout rate from cognitive-behavioral group treatment for bulimia nervosa. 762 Apr 71

The level and direction of hostility in patients with bulimia nervosa, anorexia nervosa and a comparison group were measured using the the Hostility and Direction of Hostility Questionnaire. A semistructured interview developed by Harris, Brown, and Bifulco (Psychological Medicine, 16, 641-659, 1986) was used to assess childhood care to examine whether a link exists between childhood exposure to aggression or parental neglect and adult hostility. Patients with eating disorders had significantly higher hostility levels and were significantly more intropunitive than the comparison group. Patients with bulimia nervosa were significantly more intropunitive than the comparison group. Patients with bulimia nervosa were significantly more hostile than patients with anorexia nervosa. Anorexia nervosa patients were more likely to direct hostility inwardly, rather than outwardly, when compared with bulimia nervosa patients. Impulsivity was associated with extrapunitiveness whereas intropunitiveness was associated with depression. Although some measures of poor childhood care correlated with adult hostility levels no clear pattern emerged.
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PMID:Patterns of punitiveness in women with eating disorders. 762 Apr 76

Binge exposure with response-prevention of bingeing (ERP-B) was evaluated in 20 female Ss within an inpatient eating disorders unit over 9 sessions as an adjunct to standard milieu therapy. Subjects met DSM-III-R criteria for either bulimia nervosa (BN) (n = 13) or the bulimic subtype of anorexia nervosa (AN-B) (n = 7). The average age of the Ss in each group was 26.5 (+/- 8.8) and 24.1 +/- 6.0) yr, respectively. Results indicate significant within-session and pre-post treatment effects in self-report measures 'urge to binge', 'lack of control', 'feelings of guilt' and 'tension'. Further analysis revealed that the AN-B subgroup had significantly greater reduction in 'depression' and 'urge to vomit' compared to the BN group. This study provides preliminary evidence that ERP-B deserves further investigation with long-term follow-up in both BN and AN-B patients and may be particularly advantageous in the AN-B subpopulation.
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PMID:Exposure with response prevention treatment of anorexia nervosa-bulimic subtype and bulimia nervosa. 765 60


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