Association of serotonin and cortisol indices with childhood abuse in bulimia nervosa.
BACKGROUND
Bulimia nervosa (BN) is reported to co-occur with childhood abuse and alterations in central serotonin (5-hydroxytryptamine [5-HT]) and cortisol mechanisms. However, findings also link childhood abuse to anomalous 5-HT and cortisol function, and this motivated us to explore relationships between childhood abuse and neurobiological variations in BN.


METHODS
Thirty-five bulimic and 25 nonbulimic women were assessed for childhood physical and sexual abuse, eating symptoms, and comorbid psychopathological tendencies. These women provided blood samples for measurement of platelet hydrogen-3-paroxetine binding and serial prolactin and cortisol responses following oral administration of the partial 5-HT agonist meta-chlorophenylpiperazine (m-CPP).


RESULTS
Bulimic women showed markedly lower mean +/- SD density (B(max)) of paroxetine-binding sites (631.12 +/- 341.58) than did normal eaters (1213.00 +/- 628.74) (t(54) = -4.47; P =.001). Paroxetine binding did not vary with childhood abuse. In contrast, measures of peak change on prolactin levels after m-CPP administration (Delta-peak prolactin) indicated blunted response in abused bulimic women (7.26 +/- 7.06), nonabused bulimic women (5.62 +/- 3.95), and abused women who were normal eaters (5.73 +/- 5.19) compared with nonabused women who were normal eaters (13.57 +/- 9.94) (F(3,51) = 3.04, P =.04). Furthermore, individuals reporting childhood abuse showed decreased plasma cortisol levels relative to nonabused women who were normal eaters.


CONCLUSIONS
Findings imply that BN and childhood abuse are both generally associated with reduced 5-HT tone but that childhood abuse may be somewhat more specifically linked to reduced cortisol levels (ie, hypothalamic-pituitary-adrenal axis) activity.
Steiger
H
H
Eating Disorders Program, Douglas Hospital, 6875 LaSalle Blvd, Verdun, Quebec H4H 1R3, Canada.
Gauvin
L
L
Israël
M
M
Koerner
N
N
Ng Ying Kin
N M
NM
Paris
J
J
Young
S N
SN
D000293:Adolescent; D000328:Adult; D001792:Blood Platelets / Q000378:metabolism; D002032:Bulimia / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D002352:Carrier Proteins / Q000378:metabolism; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000378:metabolism; D010879:Piperazines / Q000494:pharmacology; D011388:Prolactin / Q000097:blood; D011955:Receptors, Drug / Q000378:metabolism; D011985:Receptors, Serotonin / Q000378:metabolism; D012621:Seasons; D012701:Serotonin / Q000378:metabolism*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism
D002352:Carrier Proteins; D010879:Piperazines; D011955:Receptors, Drug; D011985:Receptors, Serotonin; C092604:paroxetine receptor; D012701:Serotonin; D011388:Prolactin; C015068:1-(3-chlorophenyl)piperazine; D006854:Hydrocortisone