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In field studies assessing cognitive function in illicit ecstasy users, there are several frequent confounding factors that might plausibly bias the findings toward an overestimate of ecstasy-induced neurocognitive toxicity. We designed an investigation seeking to minimize these possible sources of bias. We compared illicit ecstasy users and non-users while (1) excluding individuals with significant life-time exposure to other illicit drugs or alcohol; (2) requiring that all participants be members of the 'rave' subculture; and (3) testing all participants with breath, urine and hair samples at the time of evaluation to exclude possible surreptitious substance use. We compared groups with adjustment for age, gender, race/ethnicity, family-of-origin variables and childhood history of conduct disorder and attention deficit hyperactivity disorder. We provide significance levels without correction for multiple comparisons. Field study. Fifty-two illicit ecstasy users and 59 non-users, aged 18-45 years. Battery of 15 neuropsychological tests tapping a range of cognitive functions. We found little evidence of decreased cognitive performance in ecstasy users, save for poorer strategic self-regulation, possibly reflecting increased impulsivity. However, this finding might have reflected a pre-morbid attribute of ecstasy users, rather than a residual neurotoxic effect of the drug. In a study designed to minimize limitations found in many prior investigations, we failed to demonstrate marked residual cognitive effects in ecstasy users. This finding contrasts with many previous findings-including our own-and emphasizes the need for continued caution in interpreting field studies of cognitive function in illicit ecstasy users. [ABSTRACT FROM AUTHOR]

In a study of performance-enhancing substance use among 231 experienced young male weightlifters, we found that 27 (12%) reported illicit use of human growth hormone (HGH) or its bioactive derivative, insulin-like growth factor-1. All of these 27 men also reported use of anabolic-androgenic steroids (AAS) and 22 (81%) met criteria for current or past AAS dependence. Fifteen (56%) also reported current or past dependence on opioids, cocaine, and/or ecstasy. These findings suggest that among young male weightlifters, illicit HGH use has become a common form of substance abuse, frequently associated with both AAS dependence and classical substance dependence. (Am J Addict 2010;00:1-5) [ABSTRACT FROM AUTHOR]

Aims Anabolic–androgenic steroids (AAS) are widely used illicitly to gain muscle and lose body fat. Here we review the accumulating human and animal evidence showing that AAS may cause a distinct dependence syndrome, often associated with adverse psychiatric and medical effects. Method We present an illustrative case of AAS dependence, followed by a summary of the human and animal literature on this topic, based on publications known to us or obtained by searching the PubMed database. Results About 30% of AAS users appear to develop a dependence syndrome, characterized by chronic AAS use despite adverse effects on physical, psychosocial or occupational functioning. AAS dependence shares many features with classical drug dependence. For example, hamsters will self-administer AAS, even to the point of death, and both humans and animals exhibit a well-documented AAS withdrawal syndrome, mediated by neuroendocrine and cortical neurotransmitter systems. AAS dependence may particularly involve opioidergic mechanisms. However, AAS differ from classical drugs in that they produce little immediate reward of acute intoxication, but instead a delayed effect of muscle gains. Thus standard diagnostic criteria for substance dependence, usually crafted for acutely intoxicating drugs, must be adapted slightly for cumulatively acting drugs such as AAS. Conclusions AAS dependence is a valid diagnostic entity, and probably a growing public health problem. AAS dependence may share brain mechanisms with other forms of substance dependence, especially opioid dependence. Future studies are needed to characterize AAS dependence more clearly, identify risk factors for this syndrome and develop treatment strategies. [ABSTRACT FROM AUTHOR]

Objective To assess the efficacy of duloxetine for irritable bowel syndrome (IBS). Methods We conducted an open-label 12-week trial of duloxetine 60 mg daily in 15 patients with IBS without concurrent major depressive disorder. The primary outcome measure was average abdominal pain. Secondary measures included IBS symptoms, Clinical Global Impression-Severity, Hamilton Anxiety Rating Scale, IBS Quality-of-Life Scale, and Sheehan Disability Scale. We analyzed changes using random regression and one-sample t-tests. Results Fourteen patients completed at least one post-baseline evaluation; eight completed the study. Duloxetine was associated with significant improvement (p < 0.05) in pain, severity of illness, quality of life, loose stool, work and family disability, and anxiety. However, duloxetine did not improve hard stool. Although we found no evidence of serious duloxetine toxicity, seven participants withdrew over the course of the study because of adverse drug events. Conclusions In this small, open-label study, duloxetine appeared to be effective for many features of IBS, but its adverse effects, most notably constipation, limited its use. Since our study excluded individuals with concurrent major depression, it appears that duloxetine may benefit IBS independently of its antidepressant effects. These encouraging but preliminary open-label findings support further investigation of duloxetine treatment in placebo-controlled trials of IBS. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: To estimate the familiality and heritability of binge eating disorder (BED). Method: We used a new ACE structural equation model to estimate heritability from a case-control family study of BED conducted in the Boston area. The sample consisted of 150 overweight/obese probands with lifetime BED by DSM-IV criteria, 150 overweight/obese probands without lifetime BED, and 888 of their first-degree relatives. We compared our findings with those from a study of binge eating (in the absence of compensatory behaviors) among 7,831 Norwegian twins. Results: The prevalence of BED differed by sex and by age. In the case-control family study, BED was found to aggregate in families, and heritability was estimated as 57% (CI: 30–77%). Including shared environment did not substantially improve the model's fit, nor did allowing sex-specific heritability. Findings from the twin study were similar. Conclusion: BED appears to aggregate in families and have a significant genetic component. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord, 2008 [ABSTRACT FROM AUTHOR]

Presents a study that examined the effects of media images on men's attitudes toward their body image and appearance. Review of related literature; Methodology used; Limitations of the study.

Reviews literature which focused on the issue of body image in boys. Association of distress with body image dissatisfaction; Correlation between body image satisfaction and various measures of self-esteem; Problem posed by using a single row of images of increasing size to assess boys' responses to body image questions.

Presents a study which assessed whether cultural ideals of the male body, as illustrated by `Playgirl' magazine, have changed from 1973 to 1997. Overview of studies on the evolution of society's ideals for the male body; Methodology used; Results and discussion.

Objective: We sought to compare the features of bulimic subjects in two countries (Austria and the United States). Method: To assess how bulimia nervosa presents in different cultural settings, we interviewed 33 women recruited from the University of Innsbruck, Austria, who met DSM-III-R criteria for bulimia nervosa and 33 bulimic women recruited from two universities in Massachusetts. Preliminary results on these bulimic groups have previously been reported. The present stud adds a control group of 33 Austrian women and 33 Boston women who were recruited and interviewed by identical methods. Results: Bulimic women in both countries proved significantly distinguishable from controls on eating behavior, attitudes toward body shape and weight, lifetime prevalence of major mood discarder, and a few variables regarding childhood experiences. In addition, we found several marked differences between Austria and the United States which appeared independent of the diagnosis of bulimia nervosa. The most prominent of these were satisfaction with body image and levels of substance abuse. Conclusions: Bulimia nervosa appears to exhibit stereotypic ‘core’ features which are independent of culture, but it has other features which may influenced by underlying cultural differences. [ABSTRACT FROM AUTHOR]

"Recovered memory therapy" for eating disorders and other psychiatric conditions seeks to help the patient recover repressed memories of childhood sexual abuse and other traumatic experiences. Through this technique, it is hoped that the patient can work through these experiences to achieve feller from shame, body dissatisfaction, and symptoms of depression and eating disorders. However, this method was questioned in the recent Ramona case, where a father successfully sued two therapists and a hospital for allegedly implanting false memories of childhood sexual abuse in his bulimic daughter. The testimony and verdict in this case recall the principle of primum non nocere: Although it is clearly reasonable to consider an unproven therapeutic technique in an attempt to relieve human suffering, the potential risk of the technique—in this case the possible induction of false incest memories—must be weighed carefully against the technique's expected benefits. [ABSTRACT FROM AUTHOR]

We compared 33 college women meeting DSM-III-R criteria for bulimia nervosa, recruited at Leopold Franzens Universität in Innsbruck, Austria, with 33 bulimic women recruited by identical methods at Northeastern University and Boston University in Boston, Massachusetts. Bulimia nervosa showed striking stereotypy across the two cultures. Austrian and American subjects reported similar demographic features, bulimic symptoms, severity and chronicity of illness, associated personal and familial psychiatric disorders, upbringing and family environment, and frequency of childhood sexual abuse. Only two variables, substance abuse and satisfaction with body image, differed markedly between the two groups. These differences appear to represent ambient differences between American and Austrian culture as a whole, rather than specific features of the bulimic syndrome. [ABSTRACT FROM AUTHOR]

The authors present a case of anorexia nervosa and subsequent mania both preceded by remote right-sided head injury in a young man. In spite of the apparent lack of neurologic sequelae in this case, metabolic brain imaging revealed persistent cerebral physiologic dysfunction in the right hemisphere. Furthermore, both anorexic and affective syndromes resolved with anticonvulsant treatment. The authors suggest that anorexia and bipolar affective disorder in this patient may he linked to right-sided cerebral dysfunction. [ABSTRACT FROM AUTHOR]

Three lines of evidence have suggested that electrophysiologic abnormalities may play a role in bulimia: (1) findings of abnormal EEGs in bulimic patients, (2) evidence that bulimia may respond to anticonvulsant medications, and (3) a possibly elevated frequency of seizures in bulimic patients treated with antidepressant medications. A review of these findings, together with new data from our center and others suggests that electrophysiologic abnormalities do not play a major role in bulimia (although such abnormalities may perhaps be more common in individuals with "atypical" eating disorders). However, the apparently increased frequency of seizures in bulimic patients treated with bupropion remains unexplained. Further research is needed to clarify this finding. [ABSTRACT FROM AUTHOR]

Seven studies using structured diagnostic interviews have assessed the prevalence of borderline personality disorder among patients with eating disorders, yielding rates from 0% to 42% in different samples. However, many patients with eating disorders suffer from depression, and there is substantial overlap between the symptoms of depression and those of borderline personality disorder. Thus, structured interviews for borderline personality disorder—most of which are of untested or uncertain specificity—may perhaps frequently produce false-positive diagnoses of borderline personality disorder in patients with eating disorders and hence yield exaggerated. Considering the grave implications of the borderline diagnosis, one must remain critical of studies in this area until further data, using instruments of documented specificity, blind ratings, and suitable control groups, become available. [ABSTRACT FROM AUTHOR]

Previous studies have reported that patients with bulimia often display nonsuppressed response to the dexamethasone suppression test (DST), suggesting that bulimia may be associated with hypercortisolism. To further evaluate the hypothalamic-pictuitary-adrenal axis in bulimia, 24-hour urinary free cortisol (UFC) levels and response to the 1 mg dexamethasone suppression test (DST) were assessed in 7 normal-weight women with bulimia by DSM-III. All displayed normal UFC and nonsuppressed response to the DST. [ABSTRACT FROM AUTHOR]

A confidential questionnaire, covering the DSM-III criteria for anorexia nervosa and bulimia, was administered to three samples of students, total-ling 1060 individuals, at two colleges and a secondary school. Although none of the male respondents met DSM-III criteria for either disorder, 1.0% to 4.2% of women met DSM-III criteria for a history of anorexia nervosa (with or without a history of bulimia), and an additional 6.5% to 18.6% met DSM-III criteria for a history of bulimia alone. Even when allowance is made for the number of nonrespondents, possible false-positive questionnaire responses, and the limitations of the DSM-III criteria them-selves, the prevalence rates appear substantial. Taking into account the mean ages of various samples, our results agree closely with two previous studies that each examined a single sample of students. These results augment the growing evidence that the eating disorders represent a serious public health problem. [ABSTRACT FROM AUTHOR]

The article presents a commentary of the two papers published within the special issue on the role of endophenotypes in eating disorders (EDs). According to the authors, the papers use techniques of genetic epidemiology to examine EDs, with an eye towards refining etiologic hypotheses and influencing nosology. One paper demonstrates that various anxiety disorders coaggregate with anorexia nervosa in families and the other one reviews candidate endophenotypes that may underlie EDs.