Madeline Gladis

bulimia and Depression

&NA; In recent years several lines of evidence have emerged suggesting that eating disorders in general, and bulimia in particular, are in some way linked to affective illness. However, there are few data on the frequency of affective syndromes among patients who have anorexia nervosa or bulimia. This report describes the results of semistructured interviews using the Schedule for Affective Disorders and Schizophrenia (SADS) to evaluate the frequency of the current and lifetime diagnoses of affective illness among 50 female patients meeting DSM‐III criteria for bulimia. Seventy percent of the patients had, at some time during their lives, met Research Diagnostic Criteria (RDC) for an episode of major depression and 88% had met RDC at some time during their lives for some affective disturbance. The implications of this high frequency of affective disturbance among patients with bulimia are discussed.

A double-blind trial of phenelzine in bulimia

Thirty normal weight women with bulimia completed a double-blind, placebo-controlled trial of phenelzine sulfate. The results demonstrate a significant therapeutic advantage for phenelzine over placebo. Preliminary data suggest that phenelzine may be of benefit even to non-depressed patients with bulimia.

Food Intake and Mood in Anorexia Nervosa and Bulimiaa

It is clear that patients with anorexia nervosa and bulimia have disturbances of mood, and it is likely that the mood disturbances bear an important relationship to the disturbances of eating behavior. We have as many questions, however, about the relationship between mood and eating behavior in these syndromes as we have answers. Although patients with anorexia nervosa and bulimia are frequently depressed, they fail to exhibit many of the biological characteristics of typical depressive illness, suggesting that these eating disorders are probably not simply variants of depression. Patients with bulimia appear to binge in response to dysphoric emotional states and to derive some transient relief from their bingeing. But it is unclear what facet or facets of the binge produce the alteration in emotional state, and thereby may serve to reinforce the behavior. A more detailed examination of this issue may significantly advance our understanding of the relationship between mood and food in eating disorders.

Sleep and growth hormone secretion in women athletes

Six women athletes underwent 24 h multiple sampling studies with electroencephalographic monitoring of sleep for the assessment of growth hormone secretion and sleep pattern. The athletes tended to have more stage 4 sleep, less REM activity and a similar REM density compared to 5 normal women. The nocturnal secretion of growth hormone was elevated in the first hour following sleep onset in the athletes but was otherwise not statistically different from that of the controls. As all but one of the women athletes had exercise-related menstrual irregularities, the findings reported may be associated with exercise amenorrhea.

Lactate infusions in patients with bulimia

We performed lactate infusions in 18 bulimic patients and 11 normal controls. On the basis of blind ratings, bulimic patients appeared to react to the infusion with greater anxiety than controls. The frequency of lactate-induced panic, per se, was lower in bulimic patients than rates reported for panic disorder patients. However, it would be premature to conclude that bulimia is not a heterogeneous syndrome which includes a group of patients who panic with lactate.

A DOUBLE-BLIND TRIAL OF PHENELZINE IN BULIMIA

Thirty normal weight women with bulimia completed a double-blind, placebo-controlled trial of phenelzine sulfate. The results demonstrate a significant therapeutic advantage for phenelzine over placebo. Preliminary data suggest that phenelzine may be of benefit even to non-depressed patients with bulimia.