Am J Psychiatry 1992; 149:73-81
Copyright © 1992 by American Psychiatric Association
Seasonal patterns of bulimia nervosa
A Blouin, J Blouin, P Aubin, J Carter, C Goldstein, H Boyer and E Perez
Department of Psychiatry, Ottawa Civic Hospital, Ont., Canada.
OBJECTIVE: The aim of this research was to determine whether a seasonal
pattern to symptoms of bulimia nervosa could be identified. METHOD: In
study 1, seasonal patterns of binge-purge frequency and mood were compared
between 31 patients with bulimia nervosa and 31 age-matched normal
comparison subjects, using a modified (to include binge and purge items)
version of the Seasonal Pattern Assessment Questionnaire. Study 2 involved
a cross-sectional examination of binge and purge frequency and of
depressive symptoms in 197 patients with bulimia nervosa assessed at
various months of the year over a 4-year period. RESULTS: In both the
retrospective and cross-sectional studies, binge behavior was found to be
highly associated with photoperiod. According to the modified Seasonal
Pattern Assessment Questionnaire, purging behavior and mood also varied
seasonally among patients with bulimia nervosa. However, purging behavior
and severity of depression did not appear to be related to photoperiod in
the cross-sectional study. The rate of seasonal affective disorder
(syndromal and subsyndromal) defined by the Seasonal Pattern Assessment
Questionnaire was higher among the bulimic group than the comparison
subjects, but not as high as has been reported for depression in bulimia
nervosa. CONCLUSIONS: The results strongly support the interpretation that
symptoms of bulimia nervosa primarily associated with food intake patterns
are influenced by seasonal variation, and this effect may be mediated by
light availability.
