title: Enhanced cortisol suppression in eating disorders with impulsive personality features.
abstract: Evidence of both blunted and enhanced cortisol suppression with the dexamethasone test (DST) is available in eating disorders (ED), suggesting that different subtypes of ED might be characterized by distinct neurobiological stress response dysfunctions. Other evidence indicates that ED patients with impulsive clinical features might have enhanced cortisol suppression similar to patients with impulsive personality disorders. A group of 52 patients with restrictive anorexia, binge eating-purging anorexia and bulimia nervosa were studied with a very low dose (0.25 mg) dexamethasone test and measures of phenomenology, personality and impulsivity. Patients with bulimic symptoms had significantly higher rates of cortisol suppression than controls and than restrictive anorectic patients. Percent cortisol suppression showed a strong and significant correlation with the patient's score on the Barratt Impulsiveness Scale. A hypersensitive cortisol response to dexamethasone, which might reflect hypothalamic-pituitary-adrenal axis dysfunctions might be specifically associated with impulsive subtypes of eating disorders.
authors.affiliation: Department of Psychiatry, Hospital Clínico San Carlos, C/ Martín Lagos s/n, 28040 Madrid, Spain. mdiazm.hcsc@salud.madrid.org
authors.forename: Marina
authors.initials: M
authors.lastname: Díaz-Marsá
authors.forename: Jose L
authors.initials: JL
authors.lastname: Carrasco
authors.forename: Elena
authors.initials: E
authors.lastname: Basurte
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Sáiz
authors.forename: Juan J
authors.initials: JJ
authors.lastname: López-Ibor
authors.forename: Eric
authors.initials: E
authors.lastname: Hollander
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood* / Q000175:diagnosis; D052018:Bulimia Nervosa / Q000097:blood* / Q000175:diagnosis; D003907:Dexamethasone / Q000494:pharmacology; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000378:metabolism; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone; D006854:Hydrocortisone