Self-destructiveness and serotonin function in bulimia nervosa.
Studies have linked bulimia nervosa (BN) to alterations in brain serotonin (5-hydroxytryptamine: 5-HT) activity and to heightened propensity for parasuicidality and self-injuriousness. The coincidence of self-destructiveness and 5-HT abnormality in BN is of interest, given documentation (in various populations) of an inverse association between 5-HT activity and potential for self-harm. The present study examined the connection between 5-HT status and self-destructiveness in BN. Structured interviews and self-report questionnaires were used to assess 40 bulimic and 21 normal-eater women for: (a) history of parasuicidal or self-injurious acts; and (b) mood and impulse-regulation problems. We then applied tests, presumed to reflect 5-HT function, of serial prolactin (PRL) and cortisol (CORT) responses after oral administration of the partial 5-HT agonist, meta-chlorophenylpiperazine (m-CPP). Relative to non-bulimic women, bulimic women (on average) showed blunting of PRL and CORT following m-CPP. The blunting of neuroendocrine responses was, however, most remarkable in bulimic women with a history of self-destructiveness. These findings suggest that some serotonergic anomalies reported in BN sufferers (i.e. reduced neuroendocrine response after m-CPP) may be most characteristic of individuals in the population showing clear-cut self-destructive potential.
Steiger
H
H
Eating Disorders Program, Douglas Hospital, Quebec, Verdun, Canada. stehow@douglas.mcgill.ca
Koerner
N
N
Engelberg
M J
MJ
Israël
M
M
Ng Ying Kin
N M
NM
Young
S N
SN
D000328:Adult; D001921:Brain / Q000378:metabolism*; D002032:Bulimia / Q000378:metabolism* / Q000523:psychology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D010879:Piperazines / Q000494:pharmacology; D011388:Prolactin / Q000097:blood; D011985:Receptors, Serotonin / Q000187:drug effects; D016728:Self-Injurious Behavior / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D012701:Serotonin / Q000378:metabolism*; D017366:Serotonin Receptor Agonists / Q000494:pharmacology; D012720:Severity of Illness Index; D013406:Suicide, Attempted / Q000517:prevention & control
D010879:Piperazines; D011985:Receptors, Serotonin; D017366:Serotonin Receptor Agonists; D012701:Serotonin; D011388:Prolactin; C015068:1-(3-chlorophenyl)piperazine; D006854:Hydrocortisone