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Biomedical subjects

W H Kaye

Publications and source records attributed to W H Kaye.

At least 127 records · Page 7Linked to original sources
PubMed1986

Caloric intake necessary for weight maintenance in anorexia nervosa: nonbulimics require greater caloric intake than bulimics.

In the past decade, patients with anorexia nervosa have been subdivided by the presence or absence of binging-and-purging behavior. Psychologic, physiologic, and premorbid weight differences have also been discovered between these subgroups. We now report that nonbulimic anorectics required 30-50% more caloric intake than bulimic anorectics to maintain a stable weight. This difference in caloric intake was independent of phase of illness; it was present at low weight and at intervals after weight restoration. Subjects were closely supervised on an inpatient hospital ward so that they could not binge or purge. Motor activity did not appear to explain these alterations in caloric requirements. Such differences in caloric intake could be trait related or a consequence of many years of starving or binging behavior. These findings are clinically relevant for advising eating disorder patients of caloric requirements necessary to maintain a normal weight.

Adult↗
PubMed1986

Relationship of mood alterations to bingeing behaviour in bulimia.

Twelve women with bulimia participated in a study in which they binged and vomited on the day after hospital admission. Caloric intake, time spent bingeing and vomiting, and self-reported mood ratings demonstrated much variation from subject to subject. Both subjective and objective ratings of mood indicated that anxiety decreased more frequently and to a greater extent than depression, both during and after bingeing and vomiting. The present data, obtained in a controlled setting, tend to confirm previous information on binge episodes obtained by self-report from bulimic patients. Bingeing and vomiting episodes may provide bulimic patients with a physiological mechanism for temporarily relieving a dysphoric mood state.

Adult↗
PubMed1986

Sleep EEG in Korsakoff's psychosis and Alzheimer's disease.

All-night sleep EEGs were compared in the following age-equivalent groups: seven men with Korsakoff's psychosis (KP), six men and two women with presumptive Alzheimer's disease, and six healthy men and three healthy women. KP patients had significantly increased intermittent time awake than both controls and Alzheimer patients, and shorter REM latency minus time awake than controls. Alzheimer patients had significantly reduced delta sleep than controls. Differences in the pattern of sleep EEG abnormalities may be due to different pathogenic mechanisms, but their utility in differential diagnosis requires further study.

Aged↗
PubMed1986

Comparison of calculated estimates and laboratory analysis of food offered to hospitalized eating disorder patients.

Estimation of caloric intake is an integral part of a comprehensive research/treatment program for patients with eating disorders at the National Institute of Mental Health. Caloric intakes are estimated by recording daily food intake and calculating calories using food exchange lists and food composition tables. To evaluate the validity of that method, caloric intake estimates were compared with laboratory analysis data over a 15-day period. The estimations for daily caloric intake in comparison with the laboratory analysis data were underestimated by a mean percent difference of 2.4%. The estimated carbohydrate and fat intakes were overestimated by 4.5% and 5.4%, respectively. The estimated protein intake was underestimated by 1.1%. The data suggest that estimates of caloric intake based on food exchange lists and food composition tables are within an acceptable range of error and, therefore, represent a practical approach to estimating caloric intake for patients hospitalized with an eating disorder.

Anorexia Nervosa↗
PubMed1985

Altered norepinephrine metabolism following long-term weight recovery in patients with anorexia nervosa.

This study evaluated the relationship between noradrenergic function and long-term weight recovery in patients with anorexia nervosa. Eleven patients with long-term weight maintenance (6 to 72 months) had lower plasma and cerebrospinal fluid concentrations of norepinephrine and 3-methoxy-4-hydroxy-phenylglycol than did healthy controls. Reduced noradrenergic activity may be associated with long-term stability of weight recovery in patients with anorexia nervosa.

Adolescent↗
PubMed1985

Biological alterations in the primary affective disorders and other tricyclic-responsive disorders.

Noradrenergic function was studied in patients with primary affective disorder and other tricyclic-responsive disorders including obsessive-compulsive disorder, anorexia nervosa and panic attack/agoraphobia in medication-free states. Pre-synaptic noradrenergic activity was assessed by assaying plasma concentrations of norepinephrine (NE) and its metabolite 3-methoxy,4-hydroxyphenylglycol (MHPG). Noradrenergic receptor responsiveness was evaluated by measuring plasma growth hormone (GH), MHPG, and NE responses to clonidine. Binding of tritiated dihydroergocriptine (3H-DHE) and biochemical responsiveness of alpha 2-adrenergic receptors were measured in platelet preparations. These studies suggest that noradrenergic activity may be altered in several tricyclic-responsive disorders and are consistent with the possibility that tricyclic antidepressants may serve to stabilize a dysregulated noradrenergic system in patients from several diagnostic categories.

Adult↗
PubMed1985

Adrenocorticotropin-stimulated adrenal androgen secretion in anorexia nervosa: impaired secretion at low weight with normalization after long-term weight recovery.

Adrenal androgen secretion is decreased in patients with anorexia nervosa. To assess the reversibility of the decreased secretion with recovery of body weight, we measured ACTH-stimulated adrenal androgen levels at different stages of recovery. Basal plasma GH and somatomedin-C levels also were measured, because both have been proposed as potential stimuli for adrenal androgen secretion. When studied at low body weight [58 +/- 3% (+/- SEM) ideal BW], women with anorexia nervosa had decreased ACTH-stimulated levels of dehydroepiandrosterone (DHA), DHA sulfate (DHAS), and androstenedione and decreased DHA to cortisol, DHAS to cortisol, and androstenedione to cortisol ratios compared to normal women. Women who had recently completed a refeeding program (within 2-4 weeks, 81 +/- 2% ideal BW) had an increased somatomedin-C level compared to low weight patients, but similar ACTH-stimulated adrenal androgen levels. Long term weight-recovered women (86 +/- 4% ideal BW, recovery for more than 6 months, with resumption of menses), however, had significant increases in ACTH-stimulated DHA and DHAS levels and DHA to cortisol and DHAS to cortisol ratios, and their hormone levels and ratios were not different from those in normal women. GH levels fell during weight recovery, although the values in the three patient groups did not differ significantly. We conclude that the recovery of adrenal androgen secretion while GH levels were falling provides evidence against a direct effect of GH as a stimulus for adrenal androgen secretion. The recovery of somatomedin-C before the recovery of adrenal androgens, however, and the positive correlation between plasma somatomedin-C and the integrated level of plasma DHAS (r = 0.50; P less than 0.02) are consistent with the hypothesis that somatomedin-C is a stimulus for adrenal androgen secretion.

Adrenal Glands↗
PubMed1984

Abnormalities in CNS monoamine metabolism in anorexia nervosa.

Patients with anorexia nervosa have disturbances of mood, appetite, and neuroendocrine function. Central nervous system monoamine pathways modulate these systems, and alterations in function of these systems may occur in anorexia nervosa. Because monoamine metabolism can be influenced by nutritional intake, we studied anorectics before and at intervals after correction of weight loss. Underweight anorectics had a 30% decrease in CSF homovanillic acid level and a 20% decrease in CSF 5-hydroxyindoleacetic acid concentration; these values returned to normal shortly after weight recovery. The CSF level of norepinephrine (NE) in underweight anorectics and in these patients a few weeks after weight restoration was similar to that in normal subjects. Long-term weight-recovered (20 +/- 7 months) anorectics, however, had a 50% decrease in CSF NE level compared with that of controls. Underweight anorectics have state-associated disturbances in dopamine and serotonin metabolism. Changes in NE metabolism are more complex and state independent. These abnormalities in neurotransmitter metabolism are part of the neurobiological syndrome of anorexia nervosa and may contribute to the characteristic changes in mood, behavior, and neuroendocrine function.

Adolescent↗
PubMed1984

Differences in brain serotonergic metabolism between nonbulimic and bulimic patients with anorexia nervosa.

CSF concentrations of serotonin and dopamine metabolites in 16 patients with anorexia nervosa were measured before and after probenecid administration, and the patients were studied before and at intervals after weight recovery. After probenecid administration, the weight-recovered nonbulimic anorexic patients had a higher concentration of the serotonin metabolite, 5-hydroxyindoleacetic acid, than the weight-recovered bulimic patients but no significant differences in CSF homovanillic acid. This finding is consistent with evidence that suggests a role for brain serotonin metabolism in carbohydrate and mood regulation.

Anorexia Nervosa↗
PubMed1982

Cerebrospinal fluid opioid activity in anorexia nervosa.

The authors found higher levels of CSF opioid activity, determined by radioreceptor assay, in patients with anorexia nervosa who were severely underweight than in 1) the same patients after weight restoration and 2) normal controls. Another group of patients who had chronic anorexia nervosa but were not severely underweight had normal levels of CSF opioid activity. Endogenous opioid systems have been shown to be related to eating behavior and metabolic regulation in animals. The association between decreased weight and increased CSF opioid activity observed by the authors may be a compensatory response to weight loss or may be etiologically related to anorexia nervosa.

Adult↗
PubMed1981

A double-blind controlled trial of lithium carbonate primary anorexia nervosa.

In this 4-week, double-blind, parallel group study, eight young women with primary anorexia nervosa were evaluated on lithium carbonate, and eight patients were treated with placebo and served as a control. All patients participated in a behavior modification treatment program. The lithium-treated and placebo groups were comparable on nearly all findings measured at baseline (t tests), with no significant differences observed except for calories per day, percent fat composition of the daily calories, "interpersonal sensitivity" on the Hopkins Symptom Checklist-90 (HSCL-90), "self-care" on the Goldberg Anorectic Attitude Questionnaires, (GAAQ) and "manipulation of others" on the physician-rated Psychiatric Rating Scale (PRS). The data were analyzed using repeated measures analysis of covariance (ANCOVA) with the baseline measure as the covariate. Group differences appeared in the areas of "denial or minimization of illness" on the GAAQ, "selective appetite" on the PRS, and weight. Although the repeated measures ANCOVA for weight revealed a significant group-by-time interaction, indicating nonparallelism and invalidating the test for group differences, ANCOVAs performed for each individual time point showed greater weight gain in the lithium group at weeks 3 and 4.

Adolescent↗