Laurie L. Humphries

The cytochrome P450 2D6 (CYP2D6) enzyme polymorphism: Screening costs and influence on clinical outcomes in psychiatry

This study examined factors that affect cost, reliability, and the value of determining the cytochrome P450 2D6 (CYP2D6) polymorphism in clinical practice.

Hyperamylasemia in Patients with Eating Disorders

Hyperamylasemia, which has been reported in patients with the eating disorders anorexia nervosa and bulimia, generally has been thought to result from pancreatitis. To evaluate the mechanisms of hyperamylasemia, we measured amylase, lipase, and isoamylase activity in 17 consecutive patients admitted to the eating disorder unit. Six patients had elevated amylase activity, and 5 of these 6 had isolated increases in salivary isoamylase activity. Six other patients had normal serum total amylase activity but modest elevations in the salivary isoamylase fraction. No patient developed clinical evidence of pancreatitis during hospitalization. Thus, the hyperamylasemia in patients with anorexia and bulimia often is caused by increased salivary-type amylase activity. The appropriate diagnostic test for hyperamylasemia in patients with anorexia or bulimia is the simple measurement of serum lipase or pancreatic isoamylase activity. If these levels are found to be normal, further tests to exclude pancreatitis are unnecessary.

Neuropsychological test performance of bulimic patients

Thirty subjects with DSM-III diagnoses of bulimia were compared to 30 matched controls on the Luria-Nebraska Neuropsychological Battery. The bulimics showed poorer performance on tasks associated with functioning of the right frontal cortical area, primarily tasks involving speed of drawing geometric figures. The similarities of the findings to previous findings with anorexic samples and patients with affective disorders are discussed.

Daily patterns of serotonin uptake in platelets from psychiatric patients and control volunteers

Serotonin (5-HT) uptake into platelets from psychiatric patients and controls was measured in the morning and afternoon. Uptake varied with time of day in both groups studied, resulting in four recognizable patterns. Two patterns occurred in the majority of controls. In contrast, uptake patterns in the psychiatric patients were more variable, with each of the four patterns clearly represented. However, except for the fact that uptake was significantly decreased throughout the day in depressed patients, the patterns were not otherwise linked statistically to clinical condition. In any event, the greater variability of daily 5-HT uptake patterns in patients suggests that psychiatric disorders linked presumably to central nervous system (CNS) dysfunction are in some way reflected by labile platelet 5-HT pharmacokinetics.

The Intellectual Functioning of Eating Disorder Patients

This study investigated the intellectual functioning of a large group of eating disorder patients to examine two previously reported findings: (1) this population exhibits above-average general intellectual skills; and (2) a specific pattern of strength in verbal abilities. Standard intellectual testing of 100 consecutive inpatient females with eating disorder diagnoses was performed. Results indicate intellectual performance conforming to a normal distribution with no specific pattern of strengths or weaknesses.

Tc-99m labeled triethelene tetraamine polysterene resin gastric emptying studies in bulimia patients

To evaluate gastric emptying in patients with bulimia, 20 patients (all women, ranging in age from 12 to 49 years) with upper gastrointestinal symptoms ingested 150–200 μCi 99mTc-triethelene tetraamine polysterene resin in cereal and had scintigraphy in the supine position. Data were accumulated at 5 min intervals to determine the gastric emptying time (GET). The results showed that the gastric emptying time was prolonged in 12 patients and decreased in 8. All 12 patients with prolonged emptying time were given 10 mg metoclopramide intravenously; 9 of these had a good response and 3 had no response. Although all patients had subjective symptoms of gastric dysfunction, the results indicate that about 60% had delayed and 40% had rapid gastric emptying. The findings of two extremes of gastric emptying time remain to be explained, however, this enables (a) objective documentation of gastric emptying as this technique (b) can separate those patients with rapid GET from those with prolonged GET, who might benefit from metoclopramide.

A role for Helicobacter pylori in the gastrointestinal complaints of eating disorder patients

UNLABELLED Eating disorder patients frequently present with gastrointestinal complaints. Helicobacter pylori is an etiologic factor in type B gastritis, gastric and duodenal ulcers, and may cause nausea and anorexia. OBJECTIVE To determine whether or not there is an increased prevalence of H. pylori infection in patients with eating disorders. METHOD Serum H. pylori IgG antibody and gastrointestinal symptoms were assessed in 32 patients admitted for inpatient treatment of anorexia nervosa and/or bulimia nervosa. RESULTS Eating disorder patients did not have an increased rate of detectable serum H. pylori IgG antibody. DISCUSSION There is not an increased prevalence of H. pylori infection in eating disorder patients. Thus, the increased frequency of gastrointestinal complaints in eating disorder patients cannot be attributed to H. pylori infection.

Diet composition and sex influence bioperiodicity in rat's central nervous system histamine (H1) receptors

Abstract The central histaminergic system (including histamine and its H1 receptor) has been implicated in the regulation of food intake. These studies were designed to examine both gender and dietary effects on bioperiodicity of histamine receptors (H1) in the central nervous system of rats. Groups of male or female rats were freely fed either a 25% casein diet or a 1% casein diet. Brain tissue was collected every three hours for a 27-hr period. Significant bioperiodicities in central nervous system H1 receptor binding were identified in both sexes (P

Ipecac misuse in clinical and non-clinical samples

To look at the occurrence of ipecac misuse in two high-risk populations, we distributed a structured self-report questionnaire regarding eating attitudes and behaviors to a non-clinical sample of 5,537 young women in a national collegiate social organization and to a clinical sample of 299 consecutive outpatients referred to our Eating Disorders Clinic. The lifetime prevalence of ipecac use in the college population was 2.5% compared to 10% in the outpatient sample. The prevalence rates in both populations suggest that further restriction of syrup of ipecac by warnings of toxicity on labels, package inserts, and pharmacist dispension over-the-counter should be considered

Computed tomographic abnormalities of the pancreas in eating disorders: A report of two cases with normal laparotomy

We report two patients with abdominal pain and weight loss who underwent laparotomy on the basis of computed tomographic abnormalities of the pancreas suggestive of neoplastic disease. The operations failed to reveal any gross or microscopic pathology in both instances, including one in whom a partial resection was performed. An eating disorder was belatedly diagnosed in each case. Because radiological abnormalities of the pancreas are not uncommon in patients with eating disorders, we suggest that this diagnosis be entertained before any interventional procedures are undertaken on a patient with a potential eating disorder having abnormal densities on pancreatic imaging.