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

The Personality Disorders Examination (PDE) was administered to 71 bulimia nervosa patients at baseline assessment in a study comparing the effectiveness of cognitive-behavioral treatment with desipramine or the combination of both treatments. Personality disorder subscales were combined into single DSM-III-R cluster scores. A high cluster B score (consisting of antisocial, borderline, histrionic, and narcissistic features) significantly predicted poor outcome at 16 weeks and was a better predictor of outcome than borderline personality characteristics alone or any other DSM-III-R cluster score or combination of cluster scores. In contrast pretreatment depression level, self-esteem, degree of dietary restraint, frequency of purging, and history of anorexia nervosa were not significantly related to outcome. At 1-year follow-up there was still a trend toward high cluster B scores predicting poor treatment outcome. Cluster B score was not significantly correlated with percentage of sessions attended nor did subjects with higher cluster B scores have a better outcome with either specific treatment. These results suggest that further investigation of alternative treatments is warranted with high cluster B individuals to determine if treatment effectiveness can be improved.
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PMID:Cluster B personality disorder characteristics predict outcome in the treatment of bulimia nervosa. 849 Jun 37

PIMOZIDE was given to 14 pat. with anorexia nervosa and 21 pat. with bulimia nervosa The drug evaluated positively some symptoms of eating disorders. Most significantly it improved the bulimic episodes and purging. The accompanying psychiatric symptomatology (depression and anxiety) was mostly not improved. We conclude that Pimozide may be a useful medication in the therapy of basic symptoms (bulimia, purging) in bulimic forms of eating disorders.
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PMID:[Pimozide in the treatment of psychogenic eating disorders]. 850 61

Bulimic women (N = 19) interested in a 'guided self-help group' were assessed by structured interviews and standardized tests. Eleven decided to attend the group, eight did not. Ten attenders (regular attendance of at least 6 months) and five non-attenders were followed for up to 6 months (mail questionnaires) and for 15 months (interviews) respectively. All the attenders and four non-attenders initially fulfilled DSM-III-R criteria for bulimia nervosa. After 15 months five attenders still met these criteria, whereas five improved to the point that they no longer did. Attenders showed significant improvement in specific psychopathology (drive for thinness, bulimia), general psychopathology (depression) and psychosocial adjustment, whereas non-attenders did not. However, three of five non-attenders also improved to a subclinical level, thus reflecting the natural course of the illness. Despite the small sample size our study indicates self-help as a valuable tool in overcoming an eating disorder.
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PMID:The impact of a 'guided self-help group' on bulimic women: a prospective 15 month study of attenders and non-attenders. 851 65

The frequent association of bulimia nervosa and affective disorders is well documented. Most studies on this topic have focused on the comorbidity of bulimia nervosa and unipolar depression. The literature on the comorbidity of eating disorders and bipolar disorder is more sparse. Nevertheless, an increased rate of bipolar disorder, especially bipolar II disorder, has been found by several epidemiological studies in patients with bulimia nervosa. This association might be more frequent in bulimic patients presenting with a severe chronic type of eating disorder. The relatives of bulimic patients also display an increased morbid risk for bipolar disorder. Although the comorbidity of bulimia and bipolar disorder does not appear coincidental, the nosological relationships between these two disorders are not perfectly clear. The possible relationships between seasonal affective disorders and bulimia nervosa have recently been suggested by some epidemiological studies, demonstrating that bulimia may display seasonal variations with winter worsening of bulimic symptoms. Eating symptoms are present in both winter depression and bulimia nervosa. The carbohydrate craving encountered in the former disorder could be compared to "binge eating" in bulimic patients. Epidemiological data suggest that winter depression is most frequently part of a bipolar II disorder. Few data are available concerning the therapeutic implications of the association of bulimia nervosa and bipolar disorder. Some case reports of concomitant remission of both disorders with anticonvulsivants or lithium salts have been published. However, there are no controlled studies. Anticonvulsivants or lithium salts might be indicated in some bulimic patients who do not present with a typical bipolar disorder, but who fulfill clinical criteria which are potentially predictive of a good response to such medications.
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PMID:[Comorbidity of bipolar and eating disorders. Epidemiologic and therapeutic aspects]. 852 63

Eating disorders probably result from a combination of emotional, physical, and sociologic factors and are encouraged by a society that values appearance as a measure of worth. Once believed to be a problem largely among young women, the disorders are being found increasingly among children, young athletes, men, and elderly women. Often accompanied by depression, anxiety, and personality disorders, eating disorders may be difficult to diagnose. Patients with anorexia nervosa often deny that they have a problem, despite obvious physical signs. Patients with bulimia nervosa may hide their binging and purging and have no overt signs. Primary care physicians may be the first to suspect potential problems, including a patient's fixation on food, weight, dieting, physique, and exercise. Sometimes, patients who have struggled in silence for years turn to their trusted physician for support and understanding. The first step in treatment is to address the medical complications caused by the unhealthy eating habits. Once nutritional health has been restored, patients need to reverse their entrenched and distorted body-image ideas through psychotherapy.
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PMID:Anorexia nervosa and bulimia nervosa. When the pursuit of bodily 'perfection' becomes a killer. 853 2

Symptoms of an eating disorder (hyperphagia, carbohydrate craving, and weight gain) are characteristic of wintertime depression. Recent findings suggest that the severity of bulimia nervosa peaks during fall and winter months, and that persons with this disorder respond to treatment with bright artificial light. However, the rates of eating disorders among patients presenting for the treatment of winter depression are unknown. This study was undertaken to determine these rates among 47 patients meeting the DSM-III-R criteria for major depression with a seasonal pattern. All were evaluated using standard clinical interviews and the Structured Clinical Interview for DSM-III-R. Twelve (25.5%) patients met the DSM-III-R criteria for an eating disorder. Eleven patients had onset of mood disorder during childhood or adolescence. The eating disorder followed the onset of the mood disorder. Clinicians should inquire about current and past symptoms of eating disorders when evaluating patients with winter depression.
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PMID:Bulimia and anorexia nervosa in winter depression: lifetime rates in a clinical sample. 858 Jan 21

A variety of sociocultural, familial and individual features associated with the eating disorders were examined in subjects with full syndrome (FS) and partial syndrome (PS) eating disorders and in normal high school students. The EAT-26 was administered to 995 high school students. This was followed by individual interviews with those who scored in the symptomatic range. Fifty-one students with PS eating disorders, 57 students without eating disorders (normal controls) and 30 hospital patients with FS, anorexia nervosa or bulimia nervosa were compared on subscales of the Eating Disorder Inventory, the Diagnostic Survey for Eating Disorders and the Beck Depression Inventory. The three groups displayed statistically significant differences on dimensions of EDI subscales Ineffectiveness and Interoceptive Awareness and also with respect to depression, history of being overweight and past history of emotional problems, as well as having mothers with medical illnesses. On these characteristics, the FS subjects displayed higher levels than the PS subjects, who in turn were higher than the NC subjects. The PS subjects displayed elevations on Body Dissatisfaction (EDI subscale), past medical illnesses, and mother's over-concern with eating and weight. These data support a continuum model of the eating disorders, but a continuum of multiple associated features rather than of dieting.
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PMID:The relationship of partial syndrome eating disorders to anorexia nervosa and bulimia nervosa. 858 99

Numerous studies have estimated the frequency of bulimia nervosa among high school girls and college women, but population-based trends in incidence in a community have not been reported. In this study we determined the incidence of bulimia nervosa by identifying persons residing in the community of Rochester, Minnesota, who had the disorder initially diagnosed during the 11-year period from 1980 to 1990. Using our comprehensive population-based data resource (the Rochester Epidemiology Project), we identified cases by screening 777 medical records with diagnoses of bulimia; feeding disturbance; rumination syndrome; adverse effects of cathartics, emetics, or diuretics; polyphagia; sialosis; or vomiting. We identified 103 Rochester residents (100 female and 3 male) who fulfilled DSM-III-R diagnostic criteria for bulimia nervosa during the 11-year study period. Mean +/- S.D. age for females at the time of diagnosis was 23.0 +/- 6.1 years (range, 14.4 to 40.2 years). Yearly incidence in females rose sharply from 7.4 per 100000 population in 1980 to 49.7 in 1983, and then remained relatively constant around 30 per 100000 population. The annual age-adjusted incidence rates were 26.5 per 100000 population for females and 0.8 per 100000 population for males. The overall age- and sex-adjusted annual incidence was 13.5 per 100000 population. Bulimia nervosa is a common disorder in adolescent girls and young women from 15 to 24 years of age. Histories of alcohol or drug abuse, depression, or anorexia nervosa were higher than expected in the general population.
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PMID:Bulimia nervosa in Rochester, Minnesota from 1980 to 1990. 858 3

Serotonin neurons in the rostral and caudal brainstem raphe nuclear groups give rise to collateralized ascending and descending projections which provide modulatory input into most networks throughout the entire neuraxis. The rostral raphe system is interconnected with target forebrain areas through reciprocal limbic-midbrain loops, which suggests that serotonin has a role in the regulation of complex intelligent adaptive behavior. Serotonergic pathways sensitize brainstem and spinal cord central rhythmic pattern generators which organize repetitive autonomic and motor activities, e.g. oral-buccal and nutritive behaviors, facilitate tonically active motor neurons innervating antigravity muscles, and disfacilitate somatosensory information processing. Serotonin effects are mediated by multiple receptor subtypes with distinct pre- and postsynaptic localization and regional distribution pattern. They belong to the G protein superfamily, coupling to adenylate cyclase (5-HT1,4,5,6,7) or phospholipase C (5-HT2), and to the ligand-gated ion channel superfamily (5-HT3). Drugs acting at these receptors are known to modulate various aspects of cooperative social behavior and responding latency, i.e. impulsivity, in a variety of experimental models of anxiety and depression. The clinical efficacy of the so-called selective serotonin reuptake inhibitors (SSRIs) in disorders characterized by poor impulse control, e.g. bulimia nervosa, obsessive-compulsive disorder (OCD) and violent suicidal or homicidal behavior, may likewise be due to improved responding latency.
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PMID:Psychopharmacology of central serotonergic systems. 861 4

Participants were 130 obese women with a mean age of 41.1 +/- 8.4 years and a mean weight of 97.9 +/- 13.5 kg, who reported having undertaken a mean lifetime total of 4.7 +/- 1.2 major diets on which they had lost a mean total of 45.9 +/- 21.4 kg. Participants with a severe history of weight cycling had a significantly younger age of onset of their obesity than did mild cyclers and reported initiating dieting at a significantly younger age and lower weight. No evidence, however, was found that weight cycling was associated with greater reports of depression or other psychopathology; nor was it associated with a significantly greater frequency of binge eating disorder. The results are discussed in terms of the need to use additional measures of psychological functioning.
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PMID:Psychosocial consequences of weight cycling. 869 53


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