Search PubMed⌕ Search

Biomedical subjects

R C Casper

Publications and source records attributed to R C Casper.

At least 55 records · Page 3Linked to original sources

Clonidine-induced hyperphagia in monkeys: evidence for alpha 2-noradrenergic receptor mediation.

The mechanism of clonidine-induced hyperphagia and weight gain in monkeys was studied in 11 Stumptail macaques. Clonidine induced a significant increase in food intake over baseline levels and a significant weight gain after the 3-day treatment period. Both changes induced by clonidine were antagonized by the alpha 2-noradrenergic antagonist yohimbine, but not by prazosin, an alpha 1-noradrenergic antagonist. These results suggest that clonidine-induced hyperphagia and weight gain in monkeys are mediated through alpha 2-noradrenergic receptors.

Animals↗

The self-image of adolescents with acute anorexia nervosa.

The Offer Self-Image Questionnaire for Adolescents was administered to 30 female adolescents with a diagnosis of acute anorexia nervosa. Patients were divided ianto an early group (12 to 15 years; N = 15) and a late group (16 to 19 years; N = 15). The mean percent weight loss calculated as deviation from norm weight for age and height was 32%, and the mean duration of illness was 1.3 years, similar for both groups, whereas age of onset of anorexia was significantly (P less than 0.001) different. All patients differed significantly from normal adolescents by displaying disturbances in mood and self-esteem (P less than 0.05), in social relationships (P less than 0.05), and in attitude toward sex (P less than 0.05); late adolescent patients additionally showed maladjustment in impulse control (P less than 0.05), self-perception and body image (P less than 0.01), and in general psychopathology (P less than 0.05). Patients were found well adjusted with regard to moral values, family relationships, and educational goals. The lesser adjustment problems in the younger group agree well with reports finding a more favorable prognosis for patients with an early onset of anorexia nervosa.

Adolescent↗

Bulimia. Its incidence and clinical importance in patients with anorexia nervosa.

Among the various eating patterns encountered in anorexia nervosa, the occurrence of bulimia (rapid consumption of large amounts of food in a short period of time) is a perplexing phenomenon, because its presence contradicts the common belief that patients with anorexia nervosa are always firm in their abstinence from food. We studied the eating habits of 105 hospitalized female patients within the context of a prospective treatment study on anorexia nervosa: 53% had achieved weight loss by consistently fasting, whereas 47% periodically resorted to bulimia. The two groups were contrasted with regard to their developmental and psychosocial history, clinical characteristics, and psychiatric symptomatology. Fasting patients were more introverted, more often denied hunger, and displayed little overt psychic distress. In contrast, bulimic patients were more extroverted, admitted more frequently to a strong appetite and tended to be older. Vomiting was frequent, and kleptomania almost exclusively present in bulimic patients, who manifested greater anxiety, depression, guilt, interpersonal sensitivity, and had more somatic complaints. This association of bulimia with certain personality features and a distinct psychiatric symptomatology suggests that patients with bulimia form a subgroup among patients with anorexia nervosa.

Adolescent↗

An evaluation of trace metals, vitamins, and taste function in anorexia nervosa.

Trace metals, vitamins, and other biochemical parameters were measured in 30 female patients hospitalized for anorexia nervosa with the aim of relating them to taste function, biochemical changes, and clinical signs found in this illness. Plasma zinc (71.9 +/- 14 microgram/100 ml; P < 0.01), urinary zinc (129.5 +/- 121 microgram/24 hr), and copper (84 +/- 17 microgram/100 ml; P < 0.001), were depressed, whereas zinc and copper content of hair was normal. Anorexia nervosa patients showed hypogeusia, with the bitter and sour taste most severely affected, however plasma zinc levels did not correlate with taste recognition scores. Patients showed hypercarotenemia (214 +/- 129 microgram/100 ml; P < 0.01) with normal plasma vitamin A and retinol-binding protein levels. Total iron binding capacity was depressed (261 +/- 62 microgram/100 ml; P < 0.001) in contrast to plasma iron, ceruloplasmin and folic acid, which were normal. In nine patients, who were retested before discharge, taste function improved; plasma zinc, copper, and total iron binding capacity levels increased whereas plasma carotene and cholesterol decreased to normal levels. It is concluded that the observed zinc, copper, and iron binding protein deficiencies, and hypogeusia, reflect the self-imposed nutritional restriction of anorexia nervosa patients. Zinc and other micronutrients released from catabolized tissue along with vitamin intake may mitigate against more severe deficiency states in anorexia nervosa.

Adolescent↗

Factors influencing hospital differences in weight gain in anorexia nervosa.

In a study of 105 anorexia nervosa patients, large hospital differences were found in weight gain which corresponded exactly to the amount of experience that each hospital had had in treating this disorder, and also corresponded to the degree of milieu structure imposed by each hospital. A further hypothesis to account for the hospital differences was in terms of the prognostic quality of the patients recruited to each hospital. To test the latter hypothesis, a number of prognostic indicators which had already been shown to be related to weight gain were statistically controlled by means of partial correlation. When this was done, the large hospital differences vanished, indicating that they were indeed a function of the qualities the patients brought with them to the hospital rather than what the hospital and its staff did to the patients. The results also indicate that the more experienced investigators seem to be able to recruit patients with better prognoses, whereas the less experienced ones are referred other clinicians' treatment failures.

Anorexia Nervosa↗

Clonidine induced hyperphagia and weight gain in monkeys.

The effect of the alpha-noradrenergic receptor agonist, clonidine, on food intake and weight was examined in ten adult Stumptail macaque monkeys. An intramuscular injection of 0.1 mg/kg of clonidine HCl for seven consecutive days significantly increased food intake from baseline levels throughout treatment. All but two monkeys gained weight during clonidine treatment with seven animals gaining from 5--15% of their original body weight by the end of 1 week.

Animals↗

Unique features associated with age of onset of anorexia nervosa.

The relationship between age of onset of anorexia nervosa and a variety of personal characteristics was examined in 105 patients. Age of onset of anorexia nervosa had a bimodal distribution, with peaks at 14 1/2 and 18 years. The patients whose onset of illness occurred at the later age tended to have a greater weight loss during their illness, more "underweight problems" before the onset of illness, less of the typical anorectic behaviors and attitudes, greater body disparagement, more symptoms of depression, and a greater number of previous hospitalizations. These associations suggest that an older age of onset of anorexia nervosa might predict a poor outcome.

Adolescent↗

Behaviour therapy in anorexia nervosa.

In three collaborating hospitals, 81 anorexia nervosa patients were randomly assigned to behaviour modification or its absence and followed over 35 days. There was no overall significant difference in weight gain in the two groups except in a subset of patients: those with no prior out-patient treatments.

Ambulatory Care↗

Disturbances in body image estimation as related to other characteristics and outcome in anorexia nervosa.

Body image distortion in 79 female anorexia nervosa patients were examined on a visual-size estimation apparatus during the emaciated stage of illness. Both they and an age-matched female control group overestimated their body widths, so this overestimation cannot be considered unique to anorexia nervosa. Among anorexia patients the degree of overestimation was associated with less weight gain during treatment, greater denial of illness, and several other pretreatment characteristics indicative of poor outcome.

Animals↗

Cyproheptadine in anorexia nervosa.

In three hospitals 81 female patients satisfying rigorous diagnostic criteria for anorexia nervosa were randomly allocated to one of four treatment combinations of cyproheptadine and placebo with behaviour therapy and no behaviour therapy. Cyproheptadine was found to be effective in inducing weight gain in a subgroup of anorexia nervosa patients who (a) had a history of birth delivery complications, (b) had lost 41-52 per cent weight from norm and (c) had a history of prior outpatient treatment failure. This subgroup may represent a more severe form of anorexia nervosa.

Ambulatory Care↗

Pretreatment predictors of outcome in anorexia nervosa.

The relationship of selected pretreatment characteristics to weight gain during treatment was examined in 81 anorexia nervosa patients. Good prognostic indicators correlating positively with weight gain were: no previous hospitalizations for anorexia nervosa, a great amount of overactivity before treatment, less denial of illness, less psychosexual immaturity and the admission to feeling hunger. A perinatal history of delivery complications was associated with the poor outcome predictor of prior hospitalizations.

Adolescent↗

Alterations in serum cortisol and its binding characteristics in anorexia nervosa.

The binding capacity and apparent binding affinity of corticosteroid-binding globulin (CBG) for cortisol was studied in 20 women hospitalized for anorexia nervosa. The binding capacity for cortisol, as determined kinetically at 0 C by the method of Scatchard, was similar in anorectic patients and control subjects, with mean values of 26.9 and 21.9 microgram/100 ml, respectively. The mean apparent affinity constant of CBG for cortisol was found to be significantly (P less than 0.01) lower (14.1 X 10(8) M-1) than that in control subjects (22.3 X 10(8) M-1) and was similar in blood drawn at 0830 and 2000 h. Mean morning total serum cortisol concentrations were higher in anorectic women (23.3 microgram/100 ml) than in controls (10.0 microgram/100 ml; P less than 0.001) and frequently exceeded the binding capacity of CBG. Diurnal variation was present. Mean serum 17 beta-estradiol levels were low (40.0 pg/ml) and serum progesterone was essentially absent, but mean serum testosterone levels were within the normal range. Eight patients who were retested after weight gain, when they were between 76--100% of ideal body weight, exhibited no significant changes in serum steroids or in the binding capacity or apparent affinity of CBG for cortisol.

Adolescent↗