Abstract
This study describes: 1. The therapeutic effects on anorexia nervosa (AN) and bulimia nervosa (BN) patients of a psycho-nutritional intensive day-hospital program; 2. The possible correlation between the changes observed in the psychometric tests and the variations of a number of biological parameters. Forty-six female patients (24 AN and 22 BN) were assessed through a semi-structured clinical interview based on DSM-IV criteria for Eating Disorders (ED) and a number of psychometric tests (SCL-90R, BDI, EDI-2, EAT-40, BITE, BAT) at the beginning and at the end of treatment, and after a 6-month follow-up. At these three times, we also assessed the plasma level of leptin, cortisol, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and 17β-estradiol together with body mass index (BMI) and menstrual cycle. From beginning to discharge, the scores on all psychometric tests improved in the whole sample, except for the Perfectionism subscale of EDI-2 in both groups (AN and BN), the Anger-Hostility, Phobic Anxiety and Paranoid Ideation subscales of SCL-90 and the Interpersonal Distrust subscale of EDI-2 in the BN group. At follow-up, there was a worsening of the BITE scores and of a number of EDI-2 subscales, especially in the AN subgroup — with these changes correlating with the trend of BMI. In AN patients, plasma leptin levels changed from the beginning to the end of treatment and at follow-up according to BMI changes. The mean plasma leptin level in the BN subgroup was higher than in the AN one. We found a statistically significant correlation with the scores of BDI, SCL-90R Depression and Ineffectiveness subscales, EAT-40, BITE-Symptom subscale and the trend of menses dividing these patients into two subgroups (according to the plasma leptin concentration, higher or lower than the top leptin level in the anorexics). These data seem to confirm that leptin secretion doesn’t correlate univocally to BMI.
Similar content being viewed by others
References
Campfield L.A., Smith F.J., Guisez Y., Devos R.: Recombining mouse OB protein: evidence for a peripheral signal linking adiposity and central neural networks. Science, 269, 546–549, 1995.
Zhang Y., Proenca R., Maffei M., Barone M., Leopold L., Friedman J.M.: Positional cloning of the mouse obese gene and its human homologue. Nature, 372, 425–432, 1994.
Hebebrand J., Blum W.F., Barth N., Coners H., Englaro P., Juul A., Ziegler A., Warnke A., Rascher W., Remschmidt H.: Leptin levels in patients with anorexia nervosa are reduced in the acute stage and elevated upon short-term weight restoration. Mol. Psychiatry, 2, 330–334, 1997.
Haluzìk M., Papezova H., Nedvìdkova J., Kàbrt J.: Serum leptin levels in patients with anorexia nervosa before and after partial refeeding, relationship to serum lipids and biochemical nutritional parameters. Physiol. Res., 4848, 197–202, 1999.
Herpertz S., Albers N., Wagner R., Pelz B., Kopp W., Mann K., Blum W.F., Senf W., Hebebrand J.: Longitudinal changes of circadian leptin, insulin and cortisol plasma levels and their correlation during refeeding in patients with anorexia nervosa. Eur. J. Endocrinol., 142, 373–379, 2000.
Di Carlo C., Tommaselli G.A., De Filippo E., Pisano G., Nasti A., Bifulco G., Contaldo F., Nappi C.: Menstrual status and serum leptin levels in anorectic and in menstruating women with low body mass indexes. Fertil. Steril., 78, 376–382, 2002.
Monteleone P., Di Lieto A., Tortorella A., Longobardi N., Maj M.: Circulating leptin in patients with anorexia nervosa, bulimia nervosa or binge-eating disorder: relationship to body weight, eating patterns, psychopathology and endocrine changes. Psychiatry Res., 94, 121–129, 2000.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Test Revision (DSM IV-TR) Washington, DC, APA, 2000.
Brewerton T.D., Lesem M.D., Kennedy A., Garvey W.T.: Reduced plasma leptin concentrations in bulimia nervosa. Psychoneuroendocrinology, 25, 649–658, 2000.
Jimerson D.C., Mantzoros C., Wolfe B.E., Metzger E.D.: Decreased serum leptin in bulimia nervosa. J. Clin. Endocrinol. Metab., 12, 4511–4514, 2000.
Calandra C., Musso F., Musso R.: The role of leptin in the etiopathogenesis of anorexia nervosa and bulimia. Eat. Weight Disord., 2, 130–137, 2003.
Atmaca M, Kuloglu M, Tezcan E., Ustundag B., Gecici O., Firidin B.: Serum leptin and cholesterol values in suicide attempters. Neuropsychobiology, 45, 124–127, 2002.
Westling S., Ahren B., Traskman-Bendz L., Westrin A.: Low CSF leptin in female suicide attempters with major depression. Affect. Disord., 81, 41–48, 2004.
Atmaca M., Kuloglu M., Tezcan E., Ustundag B.: Serum leptin and cholesterol levels in schizophrenic patients with and without suicide attempts. Acta Psychiatr. Scand., 108, 208–214, 2003.
Atmaca M., Kuloglu M., Tezcan E., Gecici O., Ustundag B.: Serum cholesterol and leptin levels in patients with borderline personality disorder. Neuropsychology, 45, 167–171, 2002.
Derogatis L.R.: Symptoms Check-List 90-R (SCL 90-R), scoring and procedures manual-I for the revised version. Goldbeck, Johns Hopkins School of Medicine, 1977.
Beck A.T., Steer R.A., Brown G.K.: Beck Depression Inventory. 2nd ed. The Psychological Corporation. San Antonio, Harcourt Brace & Company, 1987.
Garner D.M., Olmsted M.P., Bohr Y., Garfinkel P.E.: The Eating Attitude Test: Psychometric features and clinical correlates. Psychol. Med., 12, 871–878, 1982.
Henderson M., Freeman C.P.L.: A self-rating scale for bulimia. The BITE. Br. J. Psychiatry, 150, 18–24, 1987.
Garner D.M.: Eating Disorder Inventory-2: Professional Manual. Odessa, FL, Psychological Assessment Resources, 1991.
Probst M., Vandereycken W., Van Coppenolle H., Vanderlinden J.: Body Attitude Test for patients with an eating disorder: psychometric characteristics of a new questionnaire. Eating Disorders: The Journal of Treatment and Prevention, 3, 133–145, 1995.
Moosa M.Y., Panz V.R., Jeenah F.Y., Joffe B.I.: African women with depression: the effect of imipramine and fluoxetine on body mass index and leptin secretion. J. Clin. Psychopharmacol., 23, 549–552, 2003.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Manara, F., Manara, A. & Todisco, P. Correlation between psychometric and biological parameters in anorexic and bulimic patients during and after an intensive day hospital treatment. Eat Weight Disord 10, 236–244 (2005). https://doi.org/10.1007/BF03327490
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03327490