title: The acute salivary ghrelin response to a psychosocial stress is enhanced in symptomatic patients with bulimia nervosa: a pilot study.
abstract: BACKGROUND
  Stress is a precipitating factor for both binge eating and bulimia nervosa (BN); however, the biological mechanisms through which it may trigger binge eating are poorly understood. There is evidence that the adrenal hormone cortisol and the gastric peptide ghrelin might be involved in stress-induced food ingestion. We hypothesized that symptomatic patients with BN might disclose deranged responses of ghrelin and/or cortisol to stressors and that this could be related to their binge-eating behaviour.
  
  
  METHODS
  Here we investigated salivary cortisol and ghrelin responses to the Trier Social Stress Test (TSST) in 10 women with acute BN and 10 age-matched healthy females. Eating-related psychopathology and behaviours were assessed by self-report measures.
  
  
  RESULTS
  No significant differences emerged between bulimic patients and healthy controls in the pre-stress salivary levels of both cortisol and ghrelin. The BN patients displayed normal cortisol but enhanced ghrelin responses to TSST. No significant correlations emerged between stress-induced salivary hormone changes and self-report measures of binge eating.
  
  
  CONCLUSIONS
  To our knowledge, this is the first study showing deranged salivary ghrelin reactivity to a psychosocial stressor in symptomatic patients with BN. The extent to which this could contribute to the binge-eating behaviour of BN subjects awaits clarification.
authors.affiliation: Chair of Psychiatry, Department of Medicine and Surgery, University of Salerno, Salerno, Italy. monteri@tin.it
authors.forename: Palmiero
authors.initials: P
authors.lastname: Monteleone
authors.forename: Alfonso
authors.initials: A
authors.lastname: Tortorella
authors.forename: Pasquale
authors.initials: P
authors.lastname: Scognamiglio
authors.forename: Ismene
authors.initials: I
authors.lastname: Serino
authors.forename: Alessio Maria
authors.initials: AM
authors.lastname: Monteleone
authors.forename: Mario
authors.initials: M
authors.lastname: Maj
mesh_terms: D000328:Adult; D002032:Bulimia / Q000150:complications / Q000378:metabolism*; D052018:Bulimia Nervosa / Q000378:metabolism* / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D054439:Ghrelin / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D010865:Pilot Projects; D012463:Saliva / Q000378:metabolism; D057566:Self Report; D013315:Stress, Psychological / Q000150:complications / Q000378:metabolism*
chemical_list: D054439:Ghrelin; D006854:Hydrocortisone