PubMed Health⌕ Search

Biomedical subjects

L K Hsu

Publications and source records attributed to L K Hsu.

At least 19 recordsLinked to original sources
PubMed1992

Laboratory assessment of feeding behavior in bulimia nervosa and healthy women: methods for developing a human-feeding laboratory.

We have designed a human-feeding laboratory to be used to study feeding behavior in patients with eating disorders. Twenty-one normal-weight bulimic subjects consumed 29.711 +/- 39.940 MJ (range 0.862-178.632 MJ; 7101 +/- 9546 kcal, range 206 to 42,694 kcal) in 24 h. In comparison, 11 healthy volunteer women, when instructed to eat ad lib for 48 h, ate 7.715 +/- 2.590 MJ (1844 +/- 619 kcal) during the first 24 h and 7665 +/- 1828 MJ (1832 +/- 437 kcal) during the second 24 h. Bulimics and control subjects had a similar number of eating intervals (6.6 +/- 2.6 vs 5.0 +/- 1.7); 72% of the bulimic subjects' meals were similar in size to the meals of the controls [167-4100 kJ (40-980 kcal)] but these meals were higher in carbohydrate and lower in fat in bulemic patients. Excessive caloric intake by bulimic subjects was because 28% of their meals were very large [range 4.427-28.150 MJ (1058-6728 kcal)]. Data gathered in a laboratory setting appears to be a reasonable replication of naturalistic feeding and suggest that such a laboratory may prove useful for future studies of feeding behaviors in humans.

Adult↗
PubMed1992

Long-term mortality in anorexia nervosa. A 20-year follow-up of the St George's and Aberdeen cohorts.

Two cohorts of anorexia nervosa patients were followed up for a mean of 20 years. All except 4% of each cohort was traced. The crude mortalities were: St George's, 4%; Aberdeen, 13%. The SMRs were: St George's, 136; Aberdeen, 471. If the untraced were assumed to be dead, crude mortalities were 7.6% and 15.9% respectively, and SMRs were 276 and 592 respectively. Causes of death were complications of the illness and suicide. Medical treatment may reduce early mortality, while comprehensive medical and psychotherapeutic treatment may reduce late mortality.

Adolescent↗
PubMed1992

Bulimia nervosa in Hong Kong Chinese patients.

In contrast to the West, bulimic disorders are rarer than anorexia nervosa in Hong Kong. Four female normal-weight bulimic patients with mostly typical clinical features and conspicuous morbidity are reported. The case histories support the hypothesis that binge-eating is used to regulate unpleasant effect.

Adult↗
PubMed1991

Feeding patterns in bulimia nervosa.

We characterized the naturalistic feeding patterns of 54 women with bulimia nervosa and 11 matched controls over a continuous 24-hr period in a feeding laboratory. Overall, bulimic women consumed more calories in 24 hr (4446 +/- 584 kcal) than did controls (1845 +/- 649 kcal). Bulimic women consumed a wide range of caloric intake, with 44% overeating and 19% undereating in comparison to the range of controls. In addition, bulimics showed a disruption of circadian feeding patterns. For overeating bulimic women, the majority of meals were of normal size and frequency. Increased caloric intake in the group of overeating bulimic women was mainly due to the fact that 37% of their meals were greater than 1000 calories. Large meals occurred predominantly during the afternoon and evening and consisted primarily of dessert and snack foods. Importantly, the percentage of fat, but not carbohydrates, consumed increased as meal size, and 24-hr caloric intake increased. This study is the first to describe the naturalistic feeding characteristics of a large number of bulimics by direct observation. These findings are consistent with previous self-reports and extend and replicate previous laboratory studies. We think that laboratory studies are a reasonable replica of naturalistic feeding and should facilitate further investigation of the psychological and physiological correlates of feeding behavior in eating disorders.

Adolescent↗
PubMed1991

Circadian patterns of cortisol, prolactin, and growth hormonal secretion during bingeing and vomiting in normal weight bulimic patients.

Women who are of normal weight and have bulimia nervosa exhibit multiple neuroendocrine disturbances. We hypothesized that bingeing and vomiting behavior could be contributory because food consumption in healthy volunteers increases plasma cortisol and prolactin secretion and suppresses growth hormone secretion. Thus, we investigated the effects of bingeing and vomiting on the circadian pattern (measurements every 20 min for 24 hr) of these hormones in comparison to healthy control women eating normally. Bingeing and vomiting were associated with modest increases in cortisol and prolactin and reductions in growth hormone secretion. However, this bingeing or purging did not alter mean 24-hr pattern of cortisol and growth hormone secretion as values for bulimics were similar to controls. While mean daytime patterns of prolactin secretion were similar in bulimics and controls, bulimic patients had a significant reduction of nocturnal prolactin levels. In summary, bingeing and vomiting does not appear to have a substantial influence on hormonal secretion. However, bulimic women have blunted nocturnal prolactin patterns.

Adolescent↗
PubMed1991

Treatment of bulimia nervosa with lithium carbonate. A controlled study.

Ninety-one female bulimic outpatients received lithium carbonate or placebo on a random basis, after being separated into depressed and nondepressed subgroups, in an 8-week double-blind trial. Sixty-eight patients who completed the study experienced a significant decrease in bulimic episodes after the 8 weeks. Lithium, in a dosage yielding relatively low plasma levels, was not more effective than placebo. However, depression and other psychopathologies decreased with improvement in bulimic behavior.

Adult↗
PubMed1991

An open trial of fluoxetine in patients with anorexia nervosa.

BACKGROUND: Anorexia nervosa is a disorder of unknown etiology with a high rate of relapse and no known treatment. Because anorexia nervosa shares some similarities with obsessive compulsive disorder, we hypothesized that a serotonin-specific medication might be useful in the treatment of this illness. METHOD: We administered an open trial of fluoxetine to 31 patients with DSM-III-R anorexia nervosa. Most anorexics were started on fluoxetine treatment after inpatient weight restoration and then discharged from the hospital and followed up as outpatients. RESULTS: At the time of follow-up (11 +/- 6 months on fluoxetine), 29 of the 31 patients had maintained their weight at or above 85% average body weight (97% +/- 13% average body weight for the group). We judged response as good in 10, partial in 17, and poor in 4 anorexics as measured by improvements in eating behavior, mood, and obsessional symptoms. Restrictor anorexics responded significantly better than bulimic and/or purging-type anorexics. CONCLUSION: This open trial suggests that fluoxetine may help patients with anorexia nervosa maintain a healthy body weight as outpatients. The reasons for the positive effects of fluoxetine are uncertain, but the agent may help by improving eating behavior and/or reducing obsessionality, depression, and anxiety. It is important to emphasize that this was not a double-blind, placebo-controlled study. Thus we can not be certain of the efficacy of fluoxetine and caution that fluoxetine should not be used as the sole treatment of anorexia nervosa at this time.

Adolescent↗
PubMed1990

Experiential aspects of bulimia nervosa. Implications for cognitive behavioral therapy.

Fifty female bulimic patients were asked to complete a questionnaire describing their experience during a binge-vomit episode. Findings indicated that starvation was a common precipitant of bingeing, as were situations such as being alone and eating something, and dysphoric feelings such as anxiety and frustration. Significant others, particularly the mother and the boyfriend or husband, might also precipitate a binge. Although many feelings increased or decreased in a linear fashion as the episode progressed, others such as depression and relief waxed and waned at different points in the episode. Implications of these findings for cognitive behavior therapy were discussed.

Adolescent↗
PubMed1989

Bulimia nervosa: a four- to six-year follow-up study.

A consecutive series of 45 female bulimic patients treated by one of us was followed four to six years after termination of treatment. Thirty-five (78%) were successfully followed, six refused to participate in the study and four were untraced. At least seven (16%) had diagnosable bulimia nervosa at follow-up, and at least another seven had a subclinical form of the disorder during the six months prior to follow-up. Relapse into anorexia nervosa was uncommon, and the severity of the bulimic features had improved even among those still diagnosable as having the disorder. Affective disturbances were common among those who were bulimic. The findings were discussed in terms of the intermediate term outcome of the disorder and its identity as a clinical entity.

Adolescent↗
PubMed1988

Upper gastrointestinal tract dysfunction in bulimia.

Bulimia nervosa is a health problem of increasing magnitude that is estimated to affect 2-5% of the American adolescent and young adult female population. Because of the magnitude of this clinical problem and because of the importance of the upper gastrointestinal tract in its expression, a intradepartmental program of health care for patients affected with the disease was initiated. Eleven consecutive symptomatic bulimic individuals have been evaluated jointly by the gastroenterology and the psychiatry departments of the University of Pittsburgh. Five of these 11 individuals were found to have clinically important upper gastrointestinal pathology including ulcerative esophagitis, erosive gastritis, duodenal ulcer, and delayed gastric emptying. These gastrointestinal conditions could have been either a result of or have contributed to the symptomatology of these five patients. These data suggest that bulimic subjects have clinically important gastroenterological disease processes that require specific diagnosis and treatment independent of the psychiatric treatment provided for the bulimic condition.

Adult↗
PubMed1986

Bulimia nervosa: treatment and short-term outcome.

Fifty-six bulimia nervosa patients were treated by means of a behavioural approach and followed for at least one year after completion or dropping out of treatment. Outcome was encouraging in about half of the patients and several psychiatric indicators, such as duration of illness and response to treatment, were identified. The significance of the findings and unresolved methodological issues are discussed.

Adolescent↗
PubMed1986

The treatment of anorexia nervosa.

The author reviews recent advances in the treatment of anorexia nervosa. In addition to the usual areas of weight restoration and psychotherapy, he focuses on difficult issues such as how to engage the patient in treatment, the evaluation of the patient, treatment goals, outpatient treatment, and treatment of bulimic and chronic patients. Where expert opinions differ, the author attempts to give a balanced view while acknowledging the relative lack of research data.

Ambulatory Care↗
PubMed1986

Mania in adolescence.

The clinical features, treatment, and outcome of bipolar disorder in a consecutive series of 14 adolescent patients are described. Diagnostic confusion was common, although the clinical features were similar to those found in adult patients. Treatment response and short-term outcome seemed favorable. The findings are discussed in the light of current literature.

Adolescent↗
PubMed1979

Outcome of anorexia nervosa.

100 females with anorexia nervosa were followed up 4-8 years after first presentation. All but 12 had had refeeding and/or psychotherapy. 48 had a good outcome (weight at least near normal, regular menstruation, largely satisfactory mental state and psychosexual and psychosocial adjustments) but outcome was intermediate in 30, and poor in 20 patients. 2 had died. Poor outcome could be positively associated with clinical data such as longer duration of illness, older age of onset and presentation, lower weight during illness and at presentation, presence of symptoms such as bulimia, vomiting, and anxiety when eating with others, poor childhood social adjustment, and poor parental relationships.

Adaptation, Physiological↗