Psychological Medicine



Original Article

Mood- and restraint-based antecedents to binge episodes in bulimia nervosa: possible influences of the serotonin system 1


HOWARD STEIGER a1a2a3a4c1, LISE GAUVIN a2a5, MARLA J. ENGELBERG a4, N. M. K. NG YING KIN a2a3, MIMI ISRAEL a1a2a3, STEPHEN A. WONDERLICH a6 and JODIE RICHARDSON a1a2a4
a1 Eating Disorders Program, Douglas Hospital, Montreal, Quebec
a2 Research Centre, Douglas Hospital, Montreal, Quebec
a3 Psychiatry Department, McGill University, Montreal, Quebec
a4 Psychology Department, McGill University, Montreal, Quebec
a5 Department of Social and Preventive Medicine, GRIS (Groupe de recherche interdisciplinaire en santé – Interdisciplinary Research Group on Health), University of Montreal & The Léa-Roback Research Center on Social Inequalities of Health in Montreal, ND, USA
a6 Department of Neuroscience, University of North Dakota School of Medicine & Health Sciences, ND, USA

Article author query
steiger h   [PubMed][Google Scholar] 
gauvin l   [PubMed][Google Scholar] 
engelberg mj   [PubMed][Google Scholar] 
ying kin nm   [PubMed][Google Scholar] 
israel m   [PubMed][Google Scholar] 
wonderlich sa   [PubMed][Google Scholar] 
richardson j   [PubMed][Google Scholar] 

Abstract

Background. In bulimic syndromes, binge episodes are thought to be caused by dietary restraint and negative moods. However, as central serotonin (5-hydroxytryptamine: 5-HT) mechanisms regulate appetite and mood, the 5-HT system could be implicated in diet- and mood-based binge antecedents.

Method. We used hand-held computers to obtain repeated ‘online’ measurements of eating behaviors, moods, and self-concepts in 21 women with bulimic syndromes, and modeled 5-HT system activity with a measure of platelet [3H]paroxetine-binding density.

Results. Mood and self-concept ratings were found to be worse before binge episodes (than at other moments), and cognitive restraint was increased. After binges, mood and self-concept deteriorated further, and thoughts of dieting became more intense. Intriguingly, lower paroxetine-binding density predicted poorer mood and self-concept before a binge, larger post-binge decrements in mood and self-concept, and larger post-binge increases in dietary restraint.

Conclusions. Paroxetine binding thus seemed to reflect processes that impacted upon mood-related antecedents to binge episodes, and consequences implicating mood and dietary restraint.

(Published Online August 26 2005)


Correspondence:
c1 Eating Disorders Program, Douglas Hospital, 6875 LaSalle Blvd Montreal (Verdun), Quebec, Canada H4H 1R3. (Email: stehow@douglas.mcgill.ca)


Footnotes

1 Preliminary results from this study were presented at the annual Academy for Eating Disorders International Conference on Eating Disorders, Orlando, Florida, 2 May 2004.



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