Am J Psychiatry 1992; 149:1086-1090
Copyright © 1992 by American Psychiatric Association
CSF beta-endorphin and dynorphin in bulimia nervosa
TD Brewerton, RB Lydiard, MT Laraia, JE Shook and JC Ballenger
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425.
OBJECTIVE: Preclinical and clinical evidence suggests that central opioid
dysfunction may play a role in the pathophysiology of the eating disorders.
In particular, endogenous opioids are known to regulate feeding behavior,
mood, perception, and neuroendocrine function, all of which are disturbed
in patients with eating disorders. Although low concentrations of CSF
beta-endorphin have been reported in low-weight patients with anorexia
nervosa, central opioid activity in normal- weight patients with bulimia
nervosa has not been reported. The authors therefore measured CSF
concentrations of beta-endorphin and dynorphin in drug-free female patients
with DSM-III-R-defined bulimia nervosa and normal comparison subjects.
METHOD: After 4 days of a low monoamine diet and overnight bed rest, CSF
was obtained (12-26 cc) from 11 women with bulimia and 17 normal comparison
subjects (eight women and nine men). RESULTS: The women with bulimia had
significantly lower CSF concentrations of beta-endorphin than did the
female comparison subjects. However, CSF concentrations of dynorphin were
not significantly different in patients and female or male comparison
subjects. beta-Endorphin concentrations were inversely correlated with Beck
Depression Inventory scores and the depression subscale of the Eating
Disorders Inventory. CONCLUSIONS: These data support a role for central
opiates in the mediation of the pathophysiology of the signs and symptoms
of bulimia nervosa, although it is impossible to rule out the effects of
depression on the results.
