Biomedical subjects
Publications and source records attributed to R L Pyle.
The authors describe a series of 14 patients with bulimia nervosa who regularly spent long periods of time in saunas as a weight-control technique. This practice is probably more common in parts of the world where Finnish saunas are in widespread use. Many of these patients also engaged in other behaviors that resulted in dehydration, such as diuretic abuse and laxative abuse.
Explore the source record for details and available documents.
BACKGROUND: Trichotillomania, a disorder of hair pulling, has been considered a rare condition. Estimations of the prevalence of this disorder have been based largely on clinical experience, and there have been no estimates of its prevalence based on data collected from a large, nonclinical population. METHOD: 2579 freshman college students at two state universities and one liberal arts college were asked to provide written responses to questions designed to practically apply DSM-III-R criteria for trichotillomania and estimate the prevalence of trichotillomania in this population. RESULTS: 2534 students (97.9% of the study population) responded. We found a 0.6% lifetime prevalence of DSM-III-R trichotillomania for both male and female respondents. Hair pulling resulting in visible hair loss, but failing to meet full DSM-III-R criteria, was identified in 1.5% of males and 3.4% of females. CONCLUSION: Trichotillomania may not be as rare as previously suspected and may affect males as often as females.
Previous research on the treatment of outpatients with bulimia nervosa has focused on two treatment strategies: (1) drug therapy, primarily using tricyclic antidepressants, and (2) psychotherapy, often employing behavioral and cognitive behavioral techniques. We report here the short-term treatment outcome of a 12-week comparison trial of bulimic outpatients who were randomly assigned to one of four treatment cells: (1) imipramine hydrochloride treatment, (2) placebo treatment, (3) imipramine treatment combined with intensive group psychotherapy, and (4) placebo treatment combined with intensive group psychotherapy. All three active treatment cells resulted in significant reductions in target-eating behaviors and in a significant improvement in mood relative to placebo treatment. However, the results also suggested that the amount of improvement obtained with the intensive group psychotherapy component was superior to that obtained with antidepressant treatment alone. The addition of antidepressant treatment to the intensive group psychotherapy component did not significantly improve outcome over intensive group psychotherapy combined with placebo treatment in terms of eating behavior, but did result in more improvement in the symptoms of depression and anxiety.
In a review of the records of 454 patients with bulimia nervosa, 87 (19.2%) reported having a history of weight greater than 130% ideal body weight, although they were normal weight at evaluation. As contrasted to patients who had no history of having been overweight, this group of patients had a later onset of bulimia symptoms, weighed more and were more likely to be very dissatisfied with their current weight and to fear becoming overweight. The eating problems were similar in both groups.
Patients who have bulimia nervosa and are overweight have received little attention in the medical literature. The authors identified 25 patients who weighed greater than or equal to 130% of their ideal body weight out of a series of 591 patients with bulimia nervosa. This subgroup was contrasted with a sample of 25 patients with bulimia nervosa who were 90% to 110% of their ideal body weight. Members of the overweight bulimia nervosa group were binge-eating and vomiting less frequently than the comparison group but were more likely to be abusing laxatives, and to report a history of self-injurious behavior and suicide attempt(s). Both groups reported frequent binge-eating.
Bulimic subjects who responded to intensive group psychotherapy plus imipramine or placebo or to imipramine alone (N = 68) were assigned to 4-month maintenance with weekly support groups and/or medication (placebo or imipramine) and were evaluated 6 months after initial treatment (N = 61). Thirty percent of the subjects relapsed during the 6 months. Initial treatment with group psychotherapy plus placebo or imipramine was associated with a lower relapse rate than initial treatment with imipramine alone. Neither attendance at the maintenance group sessions nor imipramine maintenance was associated with better outcome.
Explore the source record for details and available documents.
The authors report the results of open-label antidepressant trials in a series of normal weight bulimic women who showed an inadequate response to an initial trial of imipramine hydrochloride as part of a treatment comparison study. The results indicate that a significant percentage of subjects responded to a second trial of an alternative agent. Overall, 47% had a complete remission of symptoms during the second trial, usually with a monoamine oxidase inhibitor or fluoxetine. The authors stress the importance of persisting in trials of alternative agents if bulimic patients fail to respond to an initial trial.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Two groups of bulimic patients, one group characterized by a pattern of laxative abuse for purposes of weight control and the other group characterized by no history of laxative abuse, were compared on several behavioral variables associated with bulimia. Relative to the nonabusers, the laxative abusers were more likely to abuse diuretics; to use diet pills; to chew and spit out food; and to report a history of suicide attempts, self-injurious behavior, and prior inpatient treatment for depression.
Explore the source record for details and available documents.
The authors present data on 275 patients who met DSM-III criteria for bulimia. The mean age of the patients was 24.8 years, and the average duration of illness was approximately 7 years. These patients reported a variety of abnormal eating-related behaviors: binge eating (100%), self-induced vomiting (88.1%), laxative abuse (60.6%), diuretic abuse (33.1%), and chewing and spitting out food (64.5%). Over one-third reported a history of problems with alcohol or other drugs and most indicated substantial social impairment.
Echocardiograms were obtained from 5 young Beagles (4 to 5 years of age) and from 4 old Beagles (12 to 14 years of age). Ultrasound surface transducers and esophageal transducers were used on all animals during anesthesia. Triplicate studies were performed on the 5 young Beagles over a 2-week period. The left atrioventricular valve and aortic root were identified by both procedures, whereas the right atrioventricular valve dynamics could be viewed with difficulty by the transcutaneous approach. Suitable recordings of the pulmonary valve were not obtainable with either technique. Abnormal left atrioventricular valve dynamics, characterized by a decreased closing velocity of the left atrioventricular septal cusp and increased valve thickness, were observed in 2 of the 4 aged dogs, using echocardiography. Excellent correlation between the 2 methods was evident, and minimal variation in results from one recording session to another occurred.