Carolyn E. Cochrane

Alexithymia in the eating disorders

Eating disorder patients appear to have high degrees of alexithymia, a diminished capability to verbally describe feelings, although little data exist. We administered the Toronto Alexithymia Scale (TAS) to 114 females with DSM-III-R defined eating disorders. Patients, regardless of subtype, scored significantly higher than 370 college-aged females. TAS scores were significantly correlated to self-ratings of affective symptoms, but not weight or binge-purge frequency.

Comparison of eating disorder patients with and without compulsive exercising

Several studies have examined the occurrence of eating disorders in athletes. However, little has been written about the frequency and phenomenology of compulsive exercising in eating disorder (ED) patients. Given this, we studied a series of 110 patients who presented to the Medical University of South Carolina Eating Disorders Program and met lifetime DSM-III-R criteria for bulimia nervosa (n = 71), anorexia nervosa (n = 18), or both disorders (n = 21). All patients completed the Diagnostic Survey of the Eating Disorders (DSED), a self-report measure of demographic and clinical characteristics including time spent exercising daily. Thirty-one (28%) of the 100 patients reported that they exercised > or = 60 min every day (M +/- SD = 105 +/- 48 min) and were defined as compulsive exercisers (CEs). In addition, 3 CE patients with a DSM-III-R diagnosis of eating disorder not otherwise specified (EDNOS) were included for comparison with non-CEs on a number of variables. CEs had significantly greater ratings of body dissatisfaction (p < .01) than non-CEs. Non- CEs were significantly more likely than CEs to vomit and use laxatives (p < .01, chi 2), and they had a higher frequency of binge eating ( p < .006, Kruskal-Wallis). There was a trend for a significantly higher frequency of compulsive exercising in the patients with anorexia nervosa (38.5%) than those with bulimia nervosa (22.5%) (p < or = .06, chi 2).

The role of weight control as a motivation for cocaine abuse

Heavy use of cocaine and alcohol in female cocaine abusers with eating disorders has been reported, but the prevalence and motivation for concurrent substance use has not been well investigated. This study of 37 female and 40 male cocaine abusers demonstrated that almost half of the women used cocaine and/or alcohol as a weight control measure, and 13% of the males did the same. Thirteen (72%) of 18 females endorsing weight-related use of cocaine had a current diagnosis of an eating disorder. Only two males (5%) had a past history of an eating disorder. Eleven (85%) of those women with a current eating disorder endorsed using alcohol as an appetite suppressant. These findings support the need to evaluate weight control motivation in cocaine users and to provide specific treatment aimed at addressing the interaction between the eating disorder and the substance abuse problem.

Family characteristics of binge‐eating disorder patients

Binge-eating disorder (BED) has been described and proposed as a new eating disorder diagnosis. Although studies have examined the characteristics of the family members of patients with anorexia nervosa (AN) and bulimia nervosa (BN), little is known about the characteristics of family members of BED patients. The Family Environment Scale (FES) was administered to 88 patients with a DSM-III-R diagnosis of an eating disorder (23 AN, 45 BN, 20 BN + AN), as well as 43 patients with BED as defined by DSM-IV criteria. Statistically significant differences were found among the groups on the cohesion, expressiveness, and active-recreational subscales of the FES by analysis of variance (ANOVA). On the cohesion subscale, significant differences were noted between AN and BED, p < .019, with AN scoring higher than BED. On the expressiveness subscale, significant differences were noted for BED and BN, p < .016, with BN scoring higher than BED. On the active-recreational subscale, there were significant differences for BED versus BN, BED versus AN, and BED versus AN + BN (p < .0001), with BED scoring lower than all other groups. Comparison of BED data to existing normative data yielded significant differences on the cohesion, expressiveness, conflict, independence, intellectual-cultural, active-recreational, and control subscales, with BED patients scoring higher than controls on the conflict and control subscales and lower than controls on all others. These data represent the first study of family characteristics of BED patients utilizing DSM-IV criteria, and provide a beginning understanding of family factors that may be useful in treatment.

Pergolide Mesylate: Adverse Events Occurring in the Treatment of Cocaine Dependence

In this preliminary report from a placebo-controlled, double-blind, dose-response study on the use of pergolide mesylate for cocaine dependence in outpatients 8 out of 235 subjects noted adverse events requiring breaking of the blind. Events occurred at or within 7 days of receiving the first dose of medication and included side effects (four cardiovascular, one psychiatric); drug-drug interactions (one): and clinical exclusions (two pregnancies). Two anecdotes of illicit abuse are reported. Although efficacy is unestablished, pergolide appears to be safe in the early treatment of cocaine dependence except where there are relative contraindications.

Case report of abuse of Orlistat

A case report of abuse of the anti-obesity drug, Orlistat, is reported in a normal-weight woman with an eating disorder and stimulant dependence. The case is discussed with reference to the availability of prescription drugs on the Internet, abuse of nonamphetamines and the side effect profile of Orlistat versus laxatives.

Cardiac and Mood-Related Changes During Short-Term Abstinence from Crack Cocaine: The Identification of Possible Withdrawal Phenomena

Studies assessing withdrawal phenomenon during short-term abstinence from chronic cocaine use have been limited. Although cocaine abusers are reported to be at increased risk for cardiac disorders, little research has assessed cardiac parameters in cocaine abusers and subsequent changes in these parameters that may be associated with the discontinuation of cocaine use. In this study, we categorize 441 chronic cocaine abusers into three groups based on self-reported length of abstinence from cocaine use at entry into a trial approved by the National Institute on Drug Abuse (NIDA) assessing the use of pergolide mesylate in treating relapse and craving in crack cocaine abuse. Electrocardiogram (ECG) PR intervals were found to be correlated positively with length of abstinence, returning to normal population levels within 30 days. In addition, levels of generalized anxiety, nervousness, and heart racing were found to be correlated negatively with length of abstinence from crack cocaine. This work provides preliminary evidence of cardiac and mood-related parameters that are associated with cocaine abstinence and that may indicate specific withdrawal phenomena in chronic users. In addition, these results suggest that the risk of cardiomyopathies associated with abnormal atrial-ventricular polarization may dissipate relatively quickly in abusing individuals.

Eating Disorder Pathology in a Culinary Arts School

Abstract Eating disorders (ED) have been reported to occur more frequently in association with certain occupations, such as dancing and modeling, but no data exist regarding ED frequency in the culinary arts profession. We therefore administered two diagnostic ED instruments (the Diagnostic Survey of Eating Disorders [C. Johnson, 1987] and the Eating Disorders Inventory [D. M. Garner, 1983]) to 411 students in a culinary arts school in Charleston, South Carolina. Eighteen percent had a lifetime ED diagnosis per DSM-III-R or DSM-IV Options Book criteria. Of 146 women, 5% had bulimia nervosa (BN), 21.2% had an ED not otherwise specified (EDNOS), and 4.1% had binge eating disorder (BED). Of 265 men, 1.5% had BN, 7.2% had EDNOS, and 1.9% had BED. The mean body mass index (BMI) was 24 for women and 27.6 for men. Men with an ED were heavier (BMI = 29.9±6.0) than men without an ED (BMI = 25.3C4, p < .0001). Them was no signjficant difference in BMI of women with and without an ED. Twentynine percent of the stude...

Eating disorder pathology in a culinary arts school

Eating disorders (ED) have been reported to occur more frequently in a.ssociation with certain occupations, such as dancing and modeling, but no data exist regarding ED frequency in the culinary arts profession. We therefore administered two diagnostic ED instruments (the Diagnostic Survey of Eating Disorders [C. Johnson, 1987] and the Eating Disorders Inventory [D. M. Garner, 1983]) to 411 students in a culinary arts school in Charleston, South Carolina. Eighteen percent had a lifetime ED diagnosis per DSM-III-R or DSM-IV Options Book criteria. Of 146 women, 5% had bulimia nervosa (BN), 21.2% had an ED not otherwise specified (EDNOS), and 4.1% had binge eating disorder (BED). Of265 men, 1.5% had BN, 7.2% had EDNOS, and 1.9% had BED. The mean body mass index (BM!) was 24 for women and 27.6 for men. Men with an ED were heavier (BM!= 29.9±6.0) than men without