Alterations in serotonin activity and psychiatric symptoms after recovery from bulimia nervosa
Alterations in serotonin activity and psychiatric symptoms after recovery from bulimia nervosa
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DOI：
10.1001/archpsyc.55.10.927
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发表时间：
1998-10-01
影响因子：
--
通讯作者：
Mann, JJ
中科院分区：
文献类型：
--
作者：
Kaye, WH;Greeno, CG;Mann, JJ
背景：患有神经性贪食症（BN）的女性在暴饮暴食和清除时会出现情绪和行为紊乱以及单胺活性的改变。目前尚不清楚这些改变是否继发于病理性饮食行为或可能导致 BN 发病机制的特征。方法：为了避免病理性饮食行为的混杂影响，我们研究了 30 名 BN 长期恢复（> 1 年，没有暴食或清除，体重正常，月经周期规律）的女性。受试者与 31 名健康志愿者女性进行了比较。我们评估了精神科诊断和症状，以确定康复后是否存在任何持续的行为障碍。我们测量了脑脊液 (CSF) 中血清素主要代谢物（5-羟基吲哚乙酸 [5-HIAA]）、多巴胺（高香草酸 [HVA]）和去甲肾上腺素（3-甲氧基-4-羟基苯基乙二醇 [MHPG]）的水平，以及对间氯苯基哌嗪 (m-CPP)（一种血清素特异性物质）的激素和行为反应。结果：与健康的志愿者女性相比，从 BN 中康复的女性有轻度至中度的负面情绪，对完美主义和精确性的痴迷以及夸大核心饮食失调症状。与对照女性相比，康复的 BN 女性的 CSE 5-HIAA 水平升高（117 +/- 33 vs 73 +/- 15 pmol/mL；P 小于或等于 0.001），但 CSF HVA 和 MHPG 浓度正常。康复的 BN 女性对 m-CPP 表现出焦虑和混乱的行为反应，但荷尔蒙反应正常。 结论：康复后持续存在的血清素能和行为异常表明这些心理生物学改变可能与特质相关，并有助于 BN 的发病机制。
Background: Women with bulimia nervosa (BN) have disturbances of mood and behavior and alterations of monoamine activity when they are bingeing and purging. It is not known whether these alterations are secondary to pathological eating behavior or traits that could contribute to the pathogenesis of BN.Methods: To avoid the confounding effects of pathological eating behavior, we studied 30 women after long-term recovery (>1 year with no bingeing or purging, normal weight, and regular menstrual cycles) from BN. Subjects were compared with 31 healthy volunteer women. We assessed psychiatric diagnoses and symptoms to determine whether there was any persistent disturbance of behavior after recovery. We measured cerebrospinal fluid (CSF) levels of the major metabolites of serotonin (5-hydroxyindoleacetic acid [5-HIAA]), dopamine (homovanillic acid [HVA]), and norepinephrine (3-methoxy-4-hydroxyphenylglycol [MHPG]) as well as hormonal and behavioral response to m-chlorophenylpiperazine (m-CPP), a serotonin-specific agent.Results: Women who were recovered from BN had mild to moderate negative moods and obsessions with perfectionism and exactness and exaggerated core eating disorder symptoms compared with healthy volunteer women. Recovered BN women had increased levels of CSE 5-HIAA compared with control women (117 +/- 33 vs 73 +/- 15 pmol/mL; P less than or equal to.001) but normal CSF HVA and MHPG concentrations. Recovered BN women had an anxious and disorganized behavioral response to m-CPP but a normal hormonal response.Conclusions: Persistent serotonergic and behavioral abnormalities after recovery raise the possibility that these psychobiological alterations might be trait-related and contribute to the pathogenesis of BN.