Katharine N. Dixon

REM and delta sleep in anorexia nervosa and bulimia.

Several recent investigations have suggested that neurobiological similarities may exist between patients with eating disorders and those with depression. We performed polysomnograms for two consecutive nights on nine bulimic and six anorectic patients who had no concomitant diagnosis of endogenous depression. The rapid eye movement (REM) latency, REM density, and delta sleep of these subjects on night 2 were compared to those of 10 healthy controls of similar ages. Contrary to reports of shortened REM latency and increased REM density in depressed patients, we did not find significant REM differences between eating disorder patients without endogenous depression and healthy control subjects. Low weight anorectics did appear to have less delta sleep than did controls. These findings do not support the contention that eating disorders are variants of affective disorders.

DST in bulimia without endogenous depression

Introduction The. ~x~etha~ne Suppression Test (DST) (Feinberg and Carroll 1984; Zimmerman et al. 1986) has recently been reported to be nonsuppressive in some patients with bulimia (Gwirtsman et al. 1983; Hudson et al. 1983; Mitchell et al. 1984; Lindy et al. 1985; Kiriike et al. 1986). It remains unclear, however, to what extent concomitant depression in bulimics may be contributing to the abnormal DST in this population. none were taking any medication, including ~nz~i~epines, ~ticonvulsants, or oral contraceptives, that might have interfered with the DST. None were recently withdrawn from medication. All bulimic and depressed subjects received 1 mg dex~ethasone at 1 I:00 PM within 5 days of hospi~li~tion, with cortisol levels drawn at 4:00 PM and 10:00 PM the following day. There was no evidence of any purging by any of the bulimics after receiving the dexamethasone.

Pituitary response to TRH in bulimia

The response to thyrotropin-releasing hormone (TRH) of thyroid-stimulating hormone (TSH), growth hormone (GH), and prolactin (PRL) was examined in nine normal weight female bulimics without endogenous depression and eight female controls. Four bulimics had delayed peak TSH response, but none demonstrated a blunted TSH response, unlike that which has been reported in endogenous depression. Bulimics had elevated mean +/- SD serum GH levels (controls 1.6 +/- 1.4 ng/ml, bulimics 5.6 +/- 3.9) and an inappropriate GH release following TRH. Their mean +/- SD serum PRL (3.1 +/- 1.7 ng/ml) was lower than that of controls (4.7 +/- 1.3); however, the PRL response to TRH was significantly greater in bulimics than in controls. These data show that neuroendocrine abnormalities exist in normal weight bulimic women without endogenous depression and provide further evidence for a neuroendocrine component to this illness.

Gonadotropin response to LRH in anorexia nervosa and bulimia

Women with low-weight anorexia nervosa (AN) have consistently been found to display low basal luteinizing hormone (LH) and follicle-stimulating hormone (FSH) concentrations, with reduced 24-hr LH secretion (Boyar et al. 1974; Beaumont et al. 1976; Vigersky et al. 1976). Their response to luteinizing hormone releasing hormone (LRH) has been reported to be blunted (Beaumont et al. 1976) or normal (Vigersky et al. 1976). Gonadotropins and their response to LRH have not been well studied in normal-weight bulimics. This study was designed to better describe the hypothalamic-pituitary-gonadal similarities and distinctions among anorectics, bulimits, and normal controls.

Premature termination: A risk in eating disorder groups

This study examines the influence of combined vs. conjoint psychotherapy on the phenomenon of premature termination in eating disorder groups. Thirty-eight women with a diagnosis of anorexia nervosa or bulimia enrolled in group psychotherapy were designated as group completers or premature terminators using individually defined treatment objectives. Those eating disorder patients in combined group and individual psychotherapy showed a lower frequency of premature termination than patients in conjoint group and individual psychotherapy.

Neuroendocrine Abnormalities Persist in Bulimic Women After Hospitalization

AbstractElevated basal growth hormone (GH), diminished basal prolactin (PRL), and abnormal GH, PRL, and thyrotropin (TSH) responses to thyrotropin-releasing hormone (TRH) have been described in normal-weight women with bulimia nervosa. We examined basal GH, PRL, and TSH and their response to TRH in six bulimic women before and after hospitalization. Normal hormone ranges were established in eight sex-, age-, and weight-matched controls. All bulimic women demonstrated an abnormality in at least one hormonal axis, and these abnormalities persisted despite caloric stabilization and being binge-free during a 1-month hospitalization. Unlike women with anorexia nervosa who tend to correct some endocrine abnormalities within days of caloric stabilization, bulimic women have abnormalities which persist during short-term treatment. Malnutrition cannot entirely explain the endocrine abnormalities present in bulimia.