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 12,436 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

The present study reports findings concerning the hypothesis whether patients with narcissistic self-system disturbances show more obsessive-compulsive (OC) symptoms as compared to patients without such disturbances. Ninety-one patients meeting DSM-III-R criteria for anorexia nervosa (AN) or bulimia nervosa (BN) were investigated using the Narzissmusinventar (NI), the Hamburger-Zwangsinventar (HZI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Eating Disorder Inventory (EDI). The NI-data demonstrated a great variance of self-system disturbances in AN and BN; a cluster analysis identified two different clinical features. In comparison to eating disorder patients without concomitant disturbances of the self-system (n = 34) the patient group with such narcissistic deficits (n = 57) showed significantly higher Y-BOCS and HZI-scores indicating more and severer OC symptoms. These patients also had significantly higher and hence pathologic means on seven of eight EDI scales. The results suggest that OC behaviour may be an unconscious attempt to stabilize the self-system equilibrium, i.e. counteracting narcisstic desintegration. Regulatory processes of the self-system and OC symptoms may present additional prognostic factors and lead to new approaches in psychotherapy research.
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PMID:[Obsessive-compulsive symptoms in structural ego defects--a study exemplified by anorexia and bulimia nervosa]. 770 58

The aims of the study were (1) to compare the defence style of patients with anorexia nervosa with that of patients with bulimia nervosa and of female controls; (2) to establish whether a link exists between childhood adversity and adult defence style in eating disorder patients. Twenty-six patients with restricting anorexia nervosa (RAN), 61 patients with bulimia nervosa (BN), 37 patients with bulimic anorexia nervosa or bulimia nervosa with a history of anorexia nervosa (BAN/BN-HistAN) and 88 female controls were given the short Defense Style questionnaire (Andrews, Pollock & Stewart, 1989). Eating disorder patients were asked about their childhood care using a semi-structured interview (Harris, Brown & Bifulco, 1986). Bulimia nervosa patients had a significantly less mature defence style than the other groups and like the BAN/BN-HistAN group more immature defences than the control group. In the RAN group no childhood predictors of adult defence style were found, whereas in bulimia nervosa, excessive parental control during childhood was a negative predictor of mature defences and physical abuse a positive predictor of immature defence style. These results provide some evidence that childhood adversity may constitute a vulnerability factor for the later development of bulimia nervosa, mediated by personality development.
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PMID:Childhood adversity and adult defence style in eating disorder patients--a controlled study. 812 3

This study examined the frequency of eating disorders in women with obsessive compulsive disorder (OCD). Letters were sent to area psychiatrists asking them to refer patients diagnosed with OCD to a research study. Subjects completed the Yale Brown Obsessive Compulsive Scale and a survey including history of eating disorders. Thirty-one women participated in the study. Forty-two percent (N = 13) had a past or current history of an eating disorder: 26% anorexia nervosa alone (N = 8); 3% bulimia nervosa alone (N = 1); and 13% both anorexia and bulimia (N = 4). Our study found a higher percentage of history of eating disorders than expected. Perhaps specifically asking about history of weight loss, binging, and vomiting allowed for fuller disclosure of eating disorders than other studies that relied on retrospective chart review or limited the survey to current eating symptoms. A past history of eating disorder may be more common than previously believed and may frequently precede the diagnosis of OCD.
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PMID:Eating disorder history in women with obsessive compulsive disorder. 813 42

This study sought to assess the prevalence and symptomatology of comorbid obsessive-compulsive disorder (OCD) among Japanese subjects who met the DSM-III-R criteria for bulimia nervosa (BN). The Structured Clinical Interview for DSM-III-R Patient Version was used to distinguish 26 BN patients with concurrent OCD from 52 BN patients without OCD. Obsessive-compulsive symptoms in BN subjects with concurrent OCD were evaluated using the Japanese version of the Yale-Brown Obsessive-Compulsive Scale. There were no differences in the prevalence of concurrent OCD between BN subjects with and without a lifetime history of anorexia nervosa. Among BN subjects with concurrent OCD, symptoms related to symmetry and order were most frequently identified, followed by contamination and aggressive obsessions, and checking and cleaning/washing compulsions. Bulimia nervosa subjects with concurrent OCD were more likely than subjects without OCD to have more severe mood and core eating disorder psychopathology. Comorbid OCD is a common phenomenon in Japanese bulimics (33%) similar to that suggested in BN subjects in the Western countries. Obsessive-compulsive symptoms related to symmetry and order were most frequently observed in BN subjects with concurrent OCD, which was a similar finding to that reported among restricting anorexic subjects.
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PMID:Prevalence and symptomatology of comorbid obsessive-compulsive disorder among bulimic patients. 1068 47

Obsessive-compulsive symptoms have been related to severity in the clinical presentation of eating disorders, whereas the impact of depression on the correlations between their severity and the severity of eating disorders has not been investigated. This paper assesses the effects of depression in 42 adolescent patients who met DSM-IV criteria for anorexia nervosa or bulimia nervosa by using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Eating Disorder Inventory (EDI) and the Beck Depression Inventory (BDI). The results indicate that patients who show elevated obsessionality and compulsivity on the Y-BOCS display a significantly higher degree of disturbed attitudes and behaviours concerning eating than patients with limited obsessionality and compulsivity. However, when the effects of depression are considered, all the differences found disappear. Our study suggests that depression is more directly associated with the severity of eating disorders than obsessive-compulsive symptoms and that the intensity of obsessive-compulsive symptoms in eating disorders is influenced by the intensity of depression. The relations between obsessive-compulsive symptoms, depression and eating disorders are not known. Even so this study highlights the importance of assessing depression when using obsessive and compulsive symptoms as a correlate of severity in the clinical presentation of eating disorders.
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PMID:Obsessive-compulsive symptoms as a correlate of severity in the clinical presentation of eating disorders: measuring the effects of depression. 1123 40

Data on central dopamine (DA) function in patients with Anorexia Nervosa (AN) and Bulimia Nervosa (BN) are contradictory. To tentatively clarify the brain secretory state of the amine and its relationship with the nutritional impairments and/or the psychopathological aspects of the two disorders, we measured the responses of growth hormone (GH) to acute stimulation with apomorphine (APO), a selective D-1 and D-2 receptor agonist, in 16 AN patients, 8 restricted (AN-R) and 8 bingeing-purging (AN-BP), in 7 BN patients and in 8 healthy controls (CTR). Interference of impairment of the somatotropic axis in the GH response to APO stimulation was excluded by measuring the GH and insulin-like growth factor-1 (IGF-1) basal levels and GH responses to growth hormone-releasing hormone (GHRH) stimulation. Psychological aspects of patients and controls were investigated by the rating scales Eating Disorder Inventory (E.D.I.), Bulimic Investigation Test Edinburgh (B.I.T.E)., and Yale-Brown Cornell Eating Disorder Scale (YBC-ED). Basal GH levels were significantly higher and those of IGF-1 lower in AN-R than in AN-BP, BN and CTR subjects. GH responses to GHRH stimulation were significantly higher in AN-R than in AN-BP and BN patients and in CTR. GH responses to APO stimulation were significantly lower in AN-R and AN-BP than in BN and CTR subjects, suggesting that at the hypothalamic level there is a subsensitivity of postsynaptic D-2 receptors and possibly a presynaptic DA hypersecretion. The altered GH responses to APO stimulation did not correlate with the Body Mass Index, while they correlated negatively with E.D.I. scores.
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PMID:Central dopaminergic function in anorexia and bulimia nervosa: a psychoneuroendocrine approach. 1125 59

Increased interest in body dysmorphic disorder (BDD) has generated a wealth of recent research. This paper reviews the current literature regarding conceptualizations of the disorder, the development of assessment tools, and treatment outcome. Although BDD has been viewed as a variant of an eating disorder, obsessive compulsive disorder, or a somatoform disorder, it appears best conceptualized as a body image disorder with social, psychological, and possibly biological influences. Assessment instruments with acceptable psychometric properies have been developed to specifically assess BDD (e.g., the Body Dysmorphic Disorder Examination and the Yale-Brown Obsessive Compulsive Scale modified for Body Dysmorphic Disorder). Examination and the initial results from uncontrolled and controlled treatment research suggest that cognitive behavioral treatments for BDD may be as effective as those for possibly related disorders such as obsessive compulsive disorder and bulimia nervosa.
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PMID:Body dysmorphic disorder: a review of conceptualizations, assessment, and treatment strategies. 1149 14

The purpose of the present paper was to identify the rate of prevalence of impulse control disorders (ICD) in patients with obsessive-compulsive disorder (OCD) and to compare patients with OCD with and without ICD with regard to sociodemographic, clinical and prognostic characteristics. Forty-five patients with OCD were assessed by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (4th edn, DSM-IV) plus additional modules for the assessment of ICD and examined using the Yale-Brown Obsessive-Compulsive Scale, the Clinical Global Impression, the Beck Depression Inventory, the Hamilton Depression Rating Scale, and the Global Assessment of Functioning. These patients were treated with serotonin re-uptake inhibitors (SRI) and followed for a variable period of time. Individuals with ICD (here defined as including not only the impulse control disorders not elsewhere classified of the DSM-IV, but also other disorders in which impulse control is a prominent feature such as alcohol and drug dependence, paraphilias and bulimia nervosa/binge eating disorder) were compared to those without ICD using the Mann-Whitney U-test and the Pearson's goodness of fit chi2 test. Sixteen patients with OCD (35.5%) displayed comorbid ICD. Patients with ICD were characterized by a significantly earlier age at OCD onset (P=0.04), a more insidious appearance of OCD symptoms (P=0.04), a higher rate of comorbid anxiety disorders (P=0.03), a greater number (P=0.02) and severity of compulsive symptoms (P=0.04), an increased rate of counting compulsions (P=0.02), and a higher number of required SRI trials (P=0.01). When OCD is found in association with ICD, the clinical picture is characterized by a greater severity of the obsessive-compulsive symptoms at presentation and by the requirement of a greater number of therapeutic attempts during follow up.
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PMID:Impulse control disorders in patients with obsessive-compulsive disorder. 1567 37

Blood concentrations of the satiety-inducing glucagon-like peptide-1 (GLP-1) were compared in 20 bulimic patients and 20 healthy controls to examine whether secretory impairment of the peptide could be involved in bulimia nervosa (BN). Basal GLP-1 concentrations were measured by means of an enzyme-linked immunosorbent assay (ELISA) in blood samples taken four times over a 12-h period (08.00h, 12.00h, 16.00h, 20.00h) and seven times over a 3-h period following administration of a test meal. Eating-related and non-eating related patients' psychopathological aspects were measured by the use of a battery of ad hoc rating scales (Eating Disorder Inventory-2=EDI-2, Bulimic Investigation test-Edinburgh=B.I.T.E., Montgomery-Asberg Depression Rating Scale=MADRS, Spielberger State-Trait Anxiety Inventory=STAI, Yale-Brown-Cornell Eating Disorder Scale=YBC-EDS). Basal GLP-1 values were higher in patients than in controls only in the blood samples taken at 16.00h, whereas no difference between patients and controls was observed in GLP-1 concentrations in response to the test meal stimulation. GLP-1 levels correlated positively with bingeing-vomiting frequency, with B.I.T.E. scores and the "bulimia" subitem scores of the EDI-2 scale, and negatively with the "ascetism" subitem score of the same scale.
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PMID:Glucagon-like peptide-1 secretion in bulimia nervosa. 1963 91


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