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Biomedical subjects

D Hatsukami

Publications and source records attributed to D Hatsukami.

At least 55 records · Page 3Linked to original sources

Characteristics of patients with bulimia only, bulimia with affective disorder, and bulimia with substance abuse problems.

Characteristics of patients with a diagnosis of bulimia only (N = 46), bulimia with a history of affective disorder (N = 34), and bulimia with a history of substance abuse (N = 34) were compared. Results showed that compared to patients with bulimia only or with bulimia and affective disorders, patients with bulimia and substance abuse experienced a higher rate of diuretic use to control weight, financial and work problems, stealing before and after the onset of the eating disorder, previous psychiatric inpatient treatment, and greater amount of alcohol use after the onset of the eating disorder. Both the substance abuse group and affective disorder group showed a higher incidence of attempted suicide, more social problems, and greater overall treatment rate than the bulimia only group. There were no significant differences among groups in their family histories.

Alcoholism↗

Laxative abuse as a variant of bulimia.

Two groups of bulimic patients, one group characterized by a pattern of laxative abuse for purposes of weight control and the other group characterized by no history of laxative abuse, were compared on several behavioral variables associated with bulimia. Relative to the nonabusers, the laxative abusers were more likely to abuse diuretics; to use diet pills; to chew and spit out food; and to report a history of suicide attempts, self-injurious behavior, and prior inpatient treatment for depression.

Adult↗

Characteristics of 275 patients with bulimia.

The authors present data on 275 patients who met DSM-III criteria for bulimia. The mean age of the patients was 24.8 years, and the average duration of illness was approximately 7 years. These patients reported a variety of abnormal eating-related behaviors: binge eating (100%), self-induced vomiting (88.1%), laxative abuse (60.6%), diuretic abuse (33.1%), and chewing and spitting out food (64.5%). Over one-third reported a history of problems with alcohol or other drugs and most indicated substantial social impairment.

Adolescent↗

Characterization of tobacco withdrawal: physiological and subjective effects.

In total, our studies show that changes which occur reliably and consistently in chronic smokers after tobacco deprivation include: decreased heart rate, increased caloric intake/eating, increased number of awakenings during sleep, increased craving for tobacco, and increased confusion, as measured by the POMS. Other changes that were found to occur after tobacco deprivation in some but not all of our studies include decreased orthostatic heart rate, increased irritability, and decreased vigor score on the POMS. Previous investigators have found a consistent effect of tobacco deprivation on heart rate (Gilbert and Pope 1982; Knapp et al. 1963; Parsons and Hamme 1975; Weybrew and Stark 1967; Glauser et al. 1970; Myrsten et al. 1977; Murphee and Schultz 1968). Although decreased blood pressure (Knapp et al. 1963; Murphee and Schultz 1968) and changes in other vital signs such as temperature (Gilbert and Pope 1982; Myrsten et al. 1977; Ague 1974) have been reported, our present studies and studies by others (Weybrew and Stark 1967; Glauser et al. 1970) failed to find a significant deprivation effect on these measures. Perhaps the contradictory findings are a function of the reliability of the measures themselves or of the population tested. Caloric intake has been found to increase in both animals and humans after nicotine or smoking cessation (Gruneberg 1982; Myrsten et al. 1977; Wack and Rodin 1982). These results are consistent with studies which have found that smoking cessation causes an increase in body weight (Wack and Rodin 1982). However, previous studies disagree on how smoking cessation causes weight gain. Our inpatient study is believed to be the first to simultaneously measure changes in caloric intake, fluid retention, and physical activity after tobacco deprivation. In the study, caloric intake increased but fluid retention and physical activity did not change. The increases in weight may not be accounted for solely by increases in caloric intake. There may be other factors such as decreased basal metabolic rate which cause the increase in weight. Other studies have also reported sleep disturbance or insomnia among tobacco-deprived smokers (Larson et al. 1961; Weybrew and Stark 1967). Studies directly monitoring sleep have found a decrease in duration awake (Soldatos et al. 1980), increased REM sleep (Soldatos et al. 1980; Kales et al. 1970; Parsons et al. 1975), and increased Stage IV (greater than 50% delta waves) sleep (Parson et al. 1975; Parsons and Hamme 1975). Thus, objective data indicate that after tobacco deprivation smokers actually sleep longer, which contradicts subjective reports of insomnia.(ABSTRACT TRUNCATED AT 400 WORDS)

Behavior↗

Affective disorder and substance abuse in women with bulimia.

One hundred and eight women with bulimia were evaluated for affective disorder and alcohol or drug abuse, by means of the DSM-III diagnostic criteria. In this sample, 43.5% had a history of affective disorder and 18.5% had a history of alcohol or drug abuse. Approximately 56% of the bulimia patients scored within the moderate to severe range of depression on the Beck Depression Inventory.

Alcohol Drinking↗

The dexamethasone suppression test in patients with bulimia.

In a series of 28 patients with bulimia who did not meet weight criteria for anorexia nervosa, 14 (50%) failed to suppress on the dexamethasone suppression test. Nonsuppression was not associated with degree of depression, body weight, or severity of abnormal eating-related behaviors. However, nonsuppression was associated with a higher rate of treatment for affective disorders in first-degree family members. The utility of the DST as a biologic marker for affective disorder in patients with bulimia is questioned, although a substantial level of depressive symptomatology was documented in patients with bulimia.

Adolescent↗

Electrolyte and other physiological abnormalities in patients with bulimia.

The frequencies of various forms of eating-related behaviour (such as vomiting and laxative abuse) are reported for a series of non-anorectic bulimia patients seen for evaluation in an eating disorders clinic. The results of serum electrolyte, glucose and other screening tests in these patients are presented. Electrolyte abnormalities were found in 82 of the 168 patients (48.8%) who were diagnosed as having either bulimia or atypical eating disorder. The most common abnormality was metabolic alkalosis (27.4%); hypochloremia (23.8%) and hypokalemia (13.7%) were also commonly seen. No significant blood sugar abnormalities were encountered. An elevated serum amylase level was found to be associated with frequent binge-eating and vomiting behaviour. The pathophysiology of electrolyte abnormalities in this patient group is briefly reviewed.

Adult↗

Similarities and differences on the MMPI between women with bulimia and women with alcohol or drug abuse problems.

This study compared the MMPI MacAndrew Scale, mean profile, mean scale scores, and codetypes of women with bulimia and women with alcohol or drug abuse problems. Women with alcohol or drug abuse problems scored significantly higher on the MacAndrew Scale and several mean MMPI scale scores than women with bulimia. However, mean MMPI profiles and distribution of MMPI codetypes were similar between these two groups.

Adolescent↗

Posttreatment depression in an alcohol and drug abuse population.

The prevalence and extent of relapse and the prevalence and severity of depressive symptoms were measured cross-sectionally in a group of alcohol and drug abusers (N = 842) at 1, 6, or 12 months after their discharge from alcohol or drug abuse treatment. The rate and severity of depressive symptoms for subjects who did not relapse were no higher than those found among the general population. However, among subjects who relapsed, the rate and severity of depressive symptoms were higher than those found in the general population. Women were more depressed than men after treatment, but the ratio of depressed women to men was no higher than that found in the general population.

Adult↗

Post-treatment depressive symptoms and relapse to drug use in different age groups of an alcohol and other drug abuse population.

The prevalence of relapse to alcohol or other drug use and prevalence and severity of depressive symptoms were measured cross-sectionally in different age groups of alcohol and drug abusers at one, six, and twelve months post-discharge. Relapse rates increased over time since discharge for all age groups (17 - 29, 30 - 39, 40 - 49, and 50+ years). However, no differential effect of age was found on relapse rates at each of the three post-discharge intervals. Rates of depressive symptoms increased over time since discharge only for the youngest age group. Mean depressive symptom scores increased over time since discharge only for the 17 - 29 and 50+ age groups. There were significant differences between age groups in rates of depressive symptoms at six and twelve months post-discharge and on mean depressive symptom scores at one, six and twelve months post-discharge and on mean depressive symptom scores at one, six and twelve months post-discharge. In addition, for abstinent and for relapsed subjects, there were significant differences between age groups in rates of depressive symptoms and mean depressive symptom scores. Higher rates of depressive symptoms were found in relapsed than abstinent subjects at the younger ages (17 - 29 and 30 - 39 years), with mean depressive symptom scores being higher for relapsed than abstinent subjects in all age groups.

Adolescent↗

Requesting previous psychiatric records. Do they come and are they worth obtaining?

This study examines the response rate to requests for previous records on adult psychiatric outpatients and the usefulness of the records received. Usable records were received in response to only 64.6 per cent of requests. In 40.9 per cent of the records examined, previous records revealed important information which had not been gathered at the time of outpatient evaluation. Possible reasons for the rate of response are discussed. The authors conclude that important information can be missed during the process of evaluation and that previous records may significantly add to the available data base on which to make diagnostic and treatment decisions. However, not infrequently requests for previous records are not answered.

Adult↗

Late onset bulimia.

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Adult↗

Bulimia nervosa with and without a history of anorexia nervosa.

This study compared two subgroups of women of normal weight with bulimia nervosa: those with a history of anorexia nervosa and those without such a history. Those with a history of anorexia nervosa indicated a desired body weight significantly lower than those without the history. Those with a history of anorexia nervosa were more likely to abuse laxatives and less likely to self-induce vomiting. Both groups reported feeling fat and worrying a great deal about weight and shape issues.

Adult↗