Psychological Medicine

Implications of impulsive and affective symptoms for serotonin function in bulimia nervosa

H. STEIGER a1c1, S. N. YOUNG a1, N. M. K. NG YING KIN a1, N. KOERNER a1, M. ISRAEL a1, P. LAGEIX a1 and J. PARIS a1
a1 Eating Disorders Program and Research Centre, Douglas Hospital, Verdun; and Department of Psychiatry, McGill University, Montreal, Quebec, Canada


Background. Bulimic, impulsive and depressive syndromes have all been associated with abnormalities in brain serotonin (5-hydroxytryptamine; 5-HT) mechanisms.

Methods. We had 26 bulimic women and 22 normal-eater women report impulsive, affective, self-destructive and bulimic symptoms, and then provide serial blood samples for measurement of: [3H]-paroxetine binding in platelets; and, prolactin (PRL) responses following oral meta-chlorophenyl-piperazine (m-CPP).

Results. Bulimic status was associated with markedly reduced density of paroxetine-binding sites, modest blunting of m-CPP stimulated PRL response, and greater nausea following m-CPP. Biological variables did not co-vary with most psychopathological or eating-symptom indices. However, there were inverse associations (in bulimic women only) between scores indicating impulsivity (largely ‘unreflectiveness’) and density of platelet 5-HT uptake sites.

Conclusions. Our observations link bulimia nervosa to altered 5-HT functioning, and suggest that there may be a relatively symptom-specific association between impulsivity and reduced 5-HT reuptake.

c1 Address for correspondence: Dr Howard Steiger, Eating Disorders Program, Douglas Hospital, 6875 LaSalle Boulevard, Verdun (Quebec) Canada H4H 1R3.