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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with Cushing's syndrome (CS) frequently have sleep complaints. We evaluated sleep polysomnographically in 22 patients, including 17 with pituitary-ACTH-dependent Cushing's disease (CD) and five with CS from an adrenal tumor. Data were compared to healthy controls of comparable age. Seven patients (32%) demonstrated at least mild sleep apnea (> or = 9.4 events/hour), and four of 22 (18%) had > or = 17.5 events/hour. The apneic CD and CS patients had a trend for a greater complaint of excessive daytime sleepiness. Both apneic and nonapneic groups had considerable snoring and obesity. The electroencephalographic (EEG) sleep of nonapneic patients was compared to that of normal subjects. Nonapneic CD patients differed strikingly from healthy volunteers in sleep continuity and architecture, demonstrating lighter, fragmented sleep. Rapid eye movement (REM) sleep in CD patients bore many similarities to the sleep of patients with major depression, with REM latency being significantly shortened and REM density significantly increased. Continued examination of EEG sleep in CD patients may shed light on similarities in pathophysiology between CD and major depression, disorders which are characterized by both a dysfunction of the hypothalamic-pituitary-adrenal axis and alterations in mood.
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PMID:Sleep architecture and sleep apnea in patients with Cushing's disease. 133 12

A prospective study of sixteen Chinese anorexic patients in Hong Kong indicates that they were single young females who came from lower social class, exhibited severe self-induced weight loss, rigid maintenance of low body weight and amenorrhea. Weight reduction was primarily by dietary restriction. The typical bulimic syndrome and major depression were uncommon. There were multiple aetiological factors, but no pre-morbid obesity and little pressure to pursue slimness for beauty. Instead of displaying an intense fear of obesity and a distorted body image, patients more commonly attributed poor food intake to abdominal bloating. As such, they only partially fulfilled current criteria for diagnosis. It is argued that such clinical patterns arise logically from their sociocultural backgrounds, but may gradually change with Westernization.
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PMID:Anorexia nervosa in Hong Kong: a Chinese perspective. 194 59

The first 95 patients admitted to an inpatient Eating Disorders Program and diagnosed as having bulimia (binge eating only), bulimarexia (binging and purging), and anorexia nervosa (food restriction only) were evaluated for depression, suicidality, and family history. Major depression was found in 80% of patients; 20% had made suicide attempts in their life; and 40% of those attempting suicide made potentially lethal attempts. Patients with anorexia and bulimarexia tended to be younger, single, and Protestant. Patients with bulimarexia had overeating, oversleeping, more preoccupation with suicide, and more depression in their mothers. Patients with anorexia had more relatives with anorexia and bulimarexia, and patients with bulimia had more relatives with obesity. These findings suggest that eating disorders are unique disorders and not variants of affective disorder or alcoholism.
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PMID:Depression and suicidality in eating disorders. 385 65

Binge eating disorder (BED) identified in adulthood is often clinically associated with obesity and a lifetime history of affective disorders. Several authors have suggested that dieting may predispose individuals to binge eating which then may lead to obesity. However, few BED studies have examined the chronology of the onset of binge eating, dieting, obesity, and mood disorders. This study evaluated retrospective reports from 30 women participating in a BED treatment study. Although the majority of subjects in this adult sample were obese, initiation of binge eating behavior usually occurred during adolescence at a time when most subjects reported being of normal weight. Obesity developed several years after the age of onset of meeting BED criteria. Onset of binge eating usually predated that of dieting or major depressive disorder in the majority of subjects. The results support the importance of early intervention for binge eating.
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PMID:Onset of binge eating, dieting, obesity, and mood disorders among subjects seeking treatment for binge eating disorder. 762 Apr 80

Inhibitors of serotonin (5HT) re-uptake have generally been successful in inducing modest but statistically significant weight reductions in clinical trials. Citalopram is a new, highly selective inhibitor of 5HT re-uptake. It is effective and safe in relieving major depression at doses up to 60 mg daily. In our study, 72 severely obese subjects (BMI > 44 kg/m2) were instructed in a 4500 kJ carbohydrate-rich (50%) diet. The initial two week run-in diet+placebo period was followed by a 12 week double-blind period of diet+citalopram or placebo. There were seven withdrawals during the initial two weeks. Of the remaining 65 patients, 45 were randomized to 60 mg citalopram daily and 20 received placebo. A trend towards a higher frequency of nausea at week 6 was noted in the citalopram group. Weight loss during the initial two weeks was 2.01 kg. In the following 12 weeks, mean weight loss was 3.78 kg in the citalopram group vs. 2.64 kg in the placebo group (P = 0.29), reductions occurring almost entirely during the initial four weeks of the treatment period. We conclude that citalopram is of no clinical value in the treatment of obesity when added to a 4500 kJ diet.
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PMID:Treatment of severe obesity with a highly selective serotonin re-uptake inhibitor as a supplement to a low calorie diet. 811 71

We examined predictors of outcome 1 year after completion of a randomized clinical trial assessing the additive efficacy of two forms of exposure with response prevention to a core of cognitive-behavioral therapy (CBT) for bulimia nervosa (BN). One hundred one women who met DSM-III-R criteria for BN, and who completed the clinical trial, were available for follow-up at 1 year. Predictor variables were assessed prospectively and partitioned temporally to reflect lifetime history (including personality), pretreatment clinical status, and posttreatment clinical status. Outcome was based on the frequency of binging and purging in the 3 months before assessment based on carefully constructed lifechart interviews. A series of stepwise logistic regressions were performed to determine independent predictors of 1-year outcome while controlling for treatment received. Demographic variables were unrelated to treatment outcome. A history of obesity was predictive of poor outcome, whereas a history of alcohol dependence decreased the odds of poor outcome. High self-directedness on the Temperament and Character Inventory (TCI) predicted favorable outcome at 1 year, whereas personality disorder symptoms were not predictive. Pretreatment global functioning, bulimia scores on the Eating Disorders Inventory (EDI), and the presence of major depression predicted poor outcome. Posttreatment binging, food restriction, and urges to binge on a cue reactivity assessment predicted poor outcome at 1 year. The character trait of self-directedness is a strong predictor of good outcome for CBT, and methods to enhance this trait may be worthy of investigation. Low global functioning and the presence of major depression at presentation may require additional treatment than focused CBT for BN. Our results argue for treatment goals that include abstinence from binging and restricting and decreases in urges to binge in response to high-risk cues.
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PMID:Predictors of 1-year treatment outcome in bulimia nervosa. 967 5

Psychosocial distress and psychological abnormality occurs frequently in fibromyalgia patients. Patterns of decreased levels of education, and increased rates of divorce, obesity, and smoking have been noted in clinical and epidemiological studies. Links to physical and sexual abuse have been noted as well. Major depression as well as increased rates of depression, anxiety, and somatization are also commonly found in fibromyalgia.
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PMID:Psychosocial factors and the fibromyalgia syndrome. 1002 91

The second and third generation of antidepressants, i.e., the selective serotonin reuptake inhibitors, nefazodone, venlafaxine, and mirtazapine, are proving to be useful in a variety of seemingly diverse disorders, including most anxiety disorders. In addition to receiving approval from the U.S. Food and Drug Administration (FDA) for major depressive disorder, some of the newer antidepressants have received FDA approval for other disorders, e.g., generalized anxiety disorder (venlafaxine), bulimia nervosa (fluoxetine), obsessive-compulsive disorder (fluvoxamine, paroxetine, sertraline, and fluoxetine), social phobia (paroxetine), panic disorder (sertraline, paroxetine), and posttraumatic stress disorder (sertraline). In controlled studies, these agents have also shown usefulness in premenstrual dysphoric disorder, borderline personality disorder, obesity, smoking cessation, and alcoholism. This article describes the new and potential indications for recently developed antidepressants and the studies that suggested these indications.
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PMID:New indications for antidepressants. 1181 76

Abnormalities of the production of dehydroepiandrosterone (DHEA), the adrenal androgen, have been linked with disorders such as obesity and psychological disorders such as major depression. Adrenocorticotropin (ACTH) is the primary stimulant of DHEA, and cortisol, from the adrenal. We chose to examine the DHEA and DHEA/cortisol response to the novel low-dose ACTH test in healthy subjects and a cohort with chronic fatigue syndrome (CFS): this test is useful in assessing subtle irregularities of pituitary-adrenal activity. Nineteen CFS subjects (diagnosed by CDC criteria) and 10 healthy subjects were examined. We demonstrated that 1 microg ACTH significantly elevates DHEA levels, with no difference in output between CFS and healthy subjects. The DHEA/cortisol ratio decreased in response to ACTH stimulation in healthy subjects but not in the CFS cohort. We suggest this divergence of response between the two groups represents an imbalance in the relative synthetic pathways of the CFS group which, if present chronically and if comparable to daily stressors, may manifest itself as an inappropriate response to stress. This difference may be important in either the genesis or propagation of the syndrome.
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PMID:A preliminary study of dehydroepiandrosterone response to low-dose ACTH in chronic fatigue syndrome and in healthy subjects. 1110 54

Alexithymia may be considered as a personality feature characterized by poorness of imaginary life, speech focused on actual facts and physical sensations, general inaccuracy in or paucity of the words used to express emotions, and recourse to acting out to avoid intrapsychic conflicts. The possible link between alexithymia and psychosomatic or psychopathological disorders is now well documented. In particular, studies suggested that alexithymia may be frequently observed in obese or bulimic patients. This study was designed to investigate the link between obesity and alexithymia according to the presence or not of binge eating problems; 40 obese female patients (BMI > or = 27.3) seeking obesity treatment and 32 normal weight women used as controls were included in the study. In the obese group, 11 patients (27.5%) exhibited binge-eating disorder according to the DSM IV criteria. Alexithymia was assessed using the Toronto Alexithymia Scale (TAS), and past and current mental disorders were assessed by means of the Structured Clinical Interview for DSM III-R (SCID). In addition, current depression was assessed using the Beck Depression Inventory (BDI). The mean TAS score was found significantly higher in obese patients than in controls (72.6 +/- 11.8 vs 65.2 +/- 9.3, respectively; p < 0.005). In the same way, alexithymia (defined by TAS score > or = 74) was found significantly more frequent in obese patients than in controls (52.5% vs 21.8%, respectively; p < 0.03). However, among obese patients no significant difference was found between patients with and without binge-eating disorder. Current major depression was also found significantly more frequent in obese patients than in controls (15% vs 0%, respectively; p < 0.03), and the mean BDI score was very significantly higher in obese patients (12.2 +/- 8.7 vs 4.6 +/- 4.6, respectively; p < 0.0001). Comparisons between obese patients with and without binge-eating disorder showed that only past major depression was found significantly more frequent in those with binge-eating disorder (81.8% vs 10.3%, respectively; p < 0.0001), although the mean BDI score was significantly higher in patients with binge-eating disorder (18.5 +/- 11.7 vs 9.8 +/- 5.9, respectively; p < 0.02). Group by group comparisons suggested that two factors may play a role in the correlation found between obesity and alexithymia. First, the mean TAS score was found significantly higher in subjects with low educational level (p < 0.05), obese patients exhibiting significantly lower educational level when compared to controls (p < 0.002). Then, a significant positive correlation was found between TAS scores and BDI scores (Spearman's test: p < 0.01), obese patients showing significantly higher BDI scores than controls (p < 0.0001). In order to confirm these results, a logistic regression procedure was performed in the total sample (obese patients + controls). Three factors were found significantly increasing the risk to get a TAS score > or = 74: low educational level (odds ratio: 3.56), past and/or current major depression (odds ratio: 2.77), and BDI score > or = 8 (odds ratio: 2.18). Obesity in itself had no significant effect on TAS scores. Our results confirm that alexithymia is a psychological feature frequently observed in obese patients. In our study, the correlation found between obesity and alexithymia appears to be irrespective of binge-eating disorder, and seems to be mediated by the educational level and the frequency of associated depression. However, further investigations need to be done in order to specify the relationships between obesity, alexithymia, low educational level, and depression.
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PMID:[Obesity, alexithymia, psychopathology and binge eating: a comparative study of 40 obese patients and 32 controls]. 1168 56


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