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Observational studies have shown that the El Niño–Southern Oscillation (ENSO) exerts an influence on the Quasi-Biennial Oscillation (QBO). The downward propagation of the QBO tends to speed up and slow down during El Niño and La Niña, respectively. Recent results from general circulation models have indicated that the ENSO modulation of the QBO requires a relatively high horizontal resolution, and that it does not show up in the climate models with parameterized but temporally constant gravity wave sources. Here, we demonstrate that the NASA GISS E2.2 models can capture the observed ENSO modulation of the QBO period with a horizontal resolution of 2° latitude by 2.5° longitude and its gravity wave sources parameterized interactively. This is because El Niño events lead to more vigorous gravity wave sources generating more absolute momentum fluxes over the equatorial belt, as well as less filtering of these waves into the tropical lower stratosphere through a weakening of the Walker circulation. Various components of the ENSO system such as the SSTs, the convective activities, and the Walker circulation are intimately involved in the generation and propagation of parameterized gravity waves, through which ENSO modulates the QBO period in GISS E2.2 models.

Standard vector calculus formulas of Cartesian three space are projected onto the surface of a sphere. This produces symmetric equations with three nonindependent horizontal velocity components. Each orthogonal axis has a velocity component that rotates around its axis (eastward velocity rotates around the north–south axis) and a specific angular momentum component that is the product of the velocity component multiplied by the cosine of axis' latitude. Angular momentum components align with the fixed axes and simplify several formulas, whereas the rotating velocity components are not orthogonal and vary with location. Three symmetric coordinates allow vector resolution and calculus operations continuously over the whole spherical surface, which is not possible with only two coordinates. The symmetric equations are applied to one-layer shallow water models on cubed-sphere and icosahedral grids, the latter being computationally simple and applicable to an ocean domain. Model results are presented for three different initial conditions and five different resolutions.

An assessment of simulations of the interannual variability of tropical cyclones (TCs) over the western North Pacific (WNP) and its association with El Niño–Southern Oscillation (ENSO), as well as a subsequent diagnosis for possible causes of model biases generated from simulated large-scale climate conditions, are documented in the paper. The model experiments are carried out by the Hurricane Work Group under the U.S. Climate Variability and Predictability Research Program (CLIVAR) using five global climate models (GCMs) with a total of 16 ensemble members forced by the observed sea surface temperature and spanning the 28-yr period from 1982 to 2009. The results show GISS and GFDL model ensemble means best simulate the interannual variability of TCs, and the multimodel ensemble mean (MME) follows. Also, the MME has the closest climate mean annual number of WNP TCs and the smallest root-mean-square error to the observation. Most GCMs can simulate the interannual variability of WNP TCs well, with stronger TC activities during two types of El Niño—namely, eastern Pacific (EP) and central Pacific (CP) El Niño—and weaker activity during La Niña. However, none of the models capture the differences in TC activity between EP and CP El Niño as are shown in observations. The inability of models to distinguish the differences in TC activities between the two types of El Niño events may be due to the bias of the models in response to the shift of tropical heating associated with CP El Niño.

Future tropical cyclone activity is a topic of great scientific and societal interest. In the absence of a climate theory of tropical cyclogenesis, general circulation models are the primary tool available for investigating the issue. However, the identification of tropical cyclones in model data at moderate resolution is complex, and numerous schemes have been developed for their detection. The influence of different tracking schemes on detected tropical cyclone activity and responses in the Hurricane Working Group experiments is examined herein. These are idealized atmospheric general circulation model experiments aimed at determining and distinguishing the effects of increased sea surface temperature and other increased CO2 effects on tropical cyclone activity. Two tracking schemes are applied to these data and the tracks provided by each modeling group are analyzed. The results herein indicate moderate agreement between the different tracking methods, with some models and experiments showing better agreement across schemes than others. When comparing responses between experiments, it is found that much of the disagreement between schemes is due to differences in duration, wind speed, and formation-latitude thresholds. After homogenization in these thresholds, agreement between different tracking methods is improved. However, much disagreement remains, accountable for by more fundamental differences between the tracking schemes. The results indicate that sensitivity testing and selection of objective thresholds are the key factors in obtaining meaningful, reproducible results when tracking tropical cyclones in climate model data at these resolutions, but that more fundamental differences between tracking methods can also have a significant impact on the responses in activity detected.

The global characteristics of tropical cyclones (TCs) simulated by several climate models are analyzed and compared with observations. The global climate models were forced by the same sea surface temperature (SST) fields in two types of experiments, using climatological SST and interannually varying SST. TC tracks and intensities are derived from each model's output fields by the group who ran that model, using their own preferred tracking scheme; the study considers the combination of model and tracking scheme as a single modeling system, and compares the properties derived from the different systems. Overall, the observed geographic distribution of global TC frequency was reasonably well reproduced. As expected, with the exception of one model, intensities of the simulated TC were lower than in observations, to a degree that varies considerably across models.

Simulations of the preindustrial and doubled CO2 climates are made with the GISS Global Climate Middle Atmosphere Model 3 using two different estimates of the absolute solar irradiance value: a higher value measured by solar radiometers in the 1990s and a lower value measured recently by the Solar Radiation and Climate Experiment. Each of the model simulations is adjusted to achieve global energy balance; without this adjustment the difference in irradiance produces a global temperature change of 0.4°C, comparable to the cooling estimated for the Maunder Minimum. The results indicate that by altering cloud cover the model properly compensates for the different absolute solar irradiance values on a global level when simulating both preindustrial and doubled CO2 climates. On a regional level, the preindustrial climate simulations and the patterns of change with doubled CO2 concentrations are again remarkably similar, but there are some differences. Using a higher absolute solar irradiance value and the requisite cloud cover affects the model’s depictions of high-latitude surface air temperature, sea level pressure, and stratospheric ozone, as well as tropical precipitation. In the climate change experiments it leads to an underestimation of North Atlantic warming, reduced precipitation in the tropical western Pacific, and smaller total ozone growth at high northern latitudes. Although significant, these differences are typically modest compared with the magnitude of the regional changes expected for doubled greenhouse gas concentrations. Nevertheless, the model simulations demonstrate that achieving the highest possible fidelity when simulating regional climate change requires that climate models use as input the most accurate (lower) solar irradiance value.

International audience; This paper introduces the Tropical Rain belts with an Annual cycle and a Continent Model Inter-comparison Project (TRACMIP). TRACMIP studies the dynamics of tropical rain belts and their response to past and future radiative forcings through simulations with 13 comprehensive and one simplified atmosphere models coupled to a slab ocean and driven by seasonally varying insolation. Five idealized experiments , two with an aquaplanet setup and three with a setup with an idealized tropical continent, fill the space between prescribed-SST aquaplanet simulations and realistic simulations provided by CMIP5/6. The simulations reproduce key features of present-day climate and expected future climate change, including an annual-mean intertropical convergence zone (ITCZ) that is located north of the equator and Hadley cells and eddy-driven jets that are similar to present-day climate. Quadrupling CO2 leads to a northward ITCZ shift and preferential warming in Northern high latitudes. The simulations show interesting CO2-induced changes in the seasonal excursion of the ITCZ and indicate a possible state dependence of climate sensitivity. The inclusion of an idealized continent modulates both the control climate and the response to increased CO2 ; for example, it reduces the northward ITCZ shift associated with warming and, in some models , climate sensitivity. In response to eccentricity-driven seasonal insolation changes, seasonal changes in oceanic rainfall are best characterized as a meridional dipole, while seasonal continental rainfall changes tend to be symmetric about the equator. This survey illustrates TRACMIP's potential to engender a deeper understanding of global and regional climate and to address questions on past and future climate change.

The authors describe the characteristics of tropical cyclone (TC) activity in the GISS general circulation ModelE2 with a horizontal resolution 1°×1°. Four model simulations are analysed. In the first, the model is forced with sea surface temperature (SST) from the recent historical climatology. The other three have different idealised climate change simulations, namely (1) a uniform increase of SST by 2 degrees, (2) doubling of the CO 2 concentration and (3) a combination of the two. These simulations were performed as part of the US Climate Variability and Predictability Program Hurricane Working Group. Diagnostics of standard measures of TC activity are computed from the recent historical climatological SST simulation and compared with the same measures computed from observations. The changes in TC activity in the three idealised climate change simulations, by comparison with that in the historical climatological SST simulation, are also described. Similar to previous results in the literature, the changes in TC frequency in the simulation with a doubling CO 2 and an increase in SST are approximately the linear sum of the TC frequency in the other two simulations. However, in contrast with previous results, in these simulations the effects of CO 2 and SST on TC frequency oppose each other. Large-scale environmental variables associated with TC activity are then analysed for the present and future simulations. Model biases in the large-scale fields are identified through a comparison with ERA-Interim reanalysis. Changes in the environmental fields in the future climate simulations are shown and their association with changes in TC activity discussed. Keywords: Hurricanes, global climate model, climate change (Published: 25 July 2016) Citation: Tellus A 2016, 68 , 31494, http://dx.doi.org/10.3402/tellusa.v68.31494

A realistic representation of the North Atlantic tropical cyclone tracks is crucial as it allows, for example, explaining potential changes in U.S. landfalling systems. Here, the authors present a tentative study that examines the ability of recent climate models to represent North Atlantic tropical cyclone tracks. Tracks from two types of climate models are evaluated: explicit tracks are obtained from tropical cyclones simulated in regional or global climate models with moderate to high horizontal resolution (1°–0.25°), and downscaled tracks are obtained using a downscaling technique with large-scale environmental fields from a subset of these models. For both configurations, tracks are objectively separated into four groups using a cluster technique, leading to a zonal and a meridional separation of the tracks. The meridional separation largely captures the separation between deep tropical and subtropical, hybrid or baroclinic cyclones, while the zonal separation segregates Gulf of Mexico and Cape Verde storms. The properties of the tracks’ seasonality, intensity, and power dissipation index in each cluster are documented for both configurations. The authors’ results show that, except for the seasonality, the downscaled tracks better capture the observed characteristics of the clusters. The authors also use three different idealized scenarios to examine the possible future changes of tropical cyclone tracks under 1) warming sea surface temperature, 2) increasing carbon dioxide, and 3) a combination of the two. The response to each scenario is highly variable depending on the simulation considered. Finally, the authors examine the role of each cluster in these future changes and find no preponderant contribution of any single cluster over the others.

While a quantitative climate theory of tropical cyclone formation remains elusive, considerable progress has been made recently in our ability to simulate tropical cyclone climatologies and to understand the relationship between climate and tropical cyclone formation. Climate models are now able to simulate a realistic rate of global tropical cyclone formation, although simulation of the Atlantic tropical cyclone climatology remains challenging unless horizontal resolutions finer than 50 km are employed. This article summarizes published research from the idealized experiments of the Hurricane Working Group of U.S. Climate and Ocean: Variability, Predictability and Change (CLIVAR). This work, combined with results from other model simulations, has strengthened relationships between tropical cyclone formation rates and climate variables such as midtropospheric vertical velocity, with decreased climatological vertical velocities leading to decreased tropical cyclone formation. Systematic differences are shown between experiments in which only sea surface temperature is increased compared with experiments where only atmospheric carbon dioxide is increased. Experiments where only carbon dioxide is increased are more likely to demonstrate a decrease in tropical cyclone numbers, similar to the decreases simulated by many climate models for a future, warmer climate. Experiments where the two effects are combined also show decreases in numbers, but these tend to be less for models that demonstrate a strong tropical cyclone response to increased sea surface temperatures. Further experiments are proposed that may improve our understanding of the relationship between climate and tropical cyclone formation, including experiments with two-way interaction between the ocean and the atmosphere and variations in atmospheric aerosols.

Precipitation processes in convective storms are potentially a major regulator of cloud feedback. An unresolved issue is how the partitioning of convective condensate between precipitation-size particles that fall out of updrafts and smaller particles that are detrained to form anvil clouds will change as the climate warms. Tropical Rainfall Measuring Mission (TRMM) observations of tropical oceanic convective storms indicate higher precipitation efficiency at warmer sea surface temperature (SST) but also suggest that cumulus anvil sizes, albedos, and ice water paths become insensitive to warming at high temperatures. International Satellite Cloud Climatology Project (ISCCP) data show that instantaneous cirrus and deep convective cloud fractions are positively correlated and increase with SST except at the highest temperatures, but are sensitive to variations in large-scale vertical velocity. A simple conceptual model based on a Marshall–Palmer drop size distribution, empirical terminal velocity–particle size relationships, and assumed cumulus updraft speeds reproduces the observed tendency for detrained condensate to approach a limiting value at high SST. These results suggest that the climatic behavior of observed tropical convective clouds is intermediate between the extremes required to support the thermostat and adaptive iris hypotheses.

We apply two reconstructed spectral solar forcing scenarios, one SIM (Spectral Irradiance Monitor) based, the other the SATIRE (Spectral And Total Irradiance REconstruction) modeled, as inputs to the GISS (Goddard Institute for Space Studies) GCMAM (Global Climate Middle Atmosphere Model) to examine climate responses on decadal to centennial time scales, focusing on quantifying the difference of climate response between the two solar forcing scenarios. We run the GCMAM for about 400 years with present day trace gas and aerosol for the two solar forcing inputs. We find that the SIM-based solar forcing induces much larger long-term response and 11-year variation in global averaged stratospheric temperature and column ozone. We find significant decreasing trends of planetary albedo for both forcing scenarios in the 400-year model runs. However the mechanisms for the decrease are very different. For SATIRE solar forcing, the decreasing trend of planetary albedo is associated with changes in cloud cover. For SIM-based solar forcing, without significant change in cloud cover on centennial and longer time scales, the apparent decreasing trend of planetary albedo is mainly due to out-of-phase variation in shortwave radiative forcing proxy (downwelling flux for wavelength >330 nm) and total solar irradiance (TSI). From the Maunder Minimum to present, global averaged annual mean surface air temperature has a response of ~0.1 °C to SATIRE solar forcing compared to ~0.04 °C to SIM-based solar forcing. For 11-year solar cycle, the global surface air temperature response has 3-year lagged response to either forcing scenario. The global surface air 11-year temperature response to SATIRE forcing is about 0.12 °C, similar to recent multi-model estimates, and comparable to the observational-based evidence. However, the global surface air temperature response to 11-year SIM-based solar forcing is insignificant and inconsistent with observation-based evidence.

The climate system of the Earth is endowed with a moderately strong greenhouse effect that is characterised by non-condensing greenhouse gases (GHGs) that provide the core radiative forcing. Of these, the most important is atmospheric CO 2 . There is a strong feedback contribution to the greenhouse effect by water vapour and clouds that is unique in the solar system, exceeding the core radiative forcing due to the non-condensing GHGs by a factor of three. The significance of the non-condensing GHGs is that once they have been injected into the atmosphere, they remain there virtually indefinitely because they do not condense and precipitate from the atmosphere, their chemical removal time ranging from decades to millennia. Water vapour and clouds have only a short lifespan, with their distribution determined by the locally prevailing meteorological conditions, subject to Clausius–Clapeyron constraint. Although solar irradiance is the ultimate energy source that powers the terrestrial greenhouse effect, there has been no discernable long-term trend in solar irradiance since precise monitoring began in the late 1970s. This leaves atmospheric CO 2 as the effective control knob driving the current global warming trend. Over geological time scales, volcanoes are the principal source of atmospheric CO 2 , and the weathering of rocks is the principal sink, with the biosphere participating as both a source and a sink. The problem at hand is that human industrial activity is causing atmospheric CO 2 , to increase by 2 ppm yr −1 , whereas the interglacial rate has been 0.005 ppm yr −1 . This is a geologically unprecedented rate to turn the CO 2 climate control knob. This is causing the global warming that threatens the global environment. Keywords: carbon dioxide, greenhouse effect, radiative forcing, climate change, global warming (Published: 27 November 2013) Citation: Tellus B 2013, 65 , 19734, http://dx.doi.org/10.3402/tellusb.v65i0.19734 This publication is part of a Thematic Cluster with papers presented at a conference held in Stockholm 21 - 23 May 2012, to honor the late Professor Bert Bolin for his outstanding contributions to climate science and his efforts to create a dialogue between policy makers and the scientific community. All papers within the cluster will be published online as soon as they have been accepted for publication. When all papers belonging to the cluster have been published, they will be summarized with a foreword describing the background and scope of the conference. Read the other papers from this thematic cluster here

A meta-analysis of well-controlled studies of alprazolam in depression was performed to assess the possible association of alprazolam and suicidal ideation. Pooled data from 3,217 patients (alprazolam, placebo, and various active-comparative agents) who were enrolled in 22 placebo- and/or active drug-controlled depression studies were retrospectively analyzed to evaluate the emergence, worsening, and improvement of suicidal ideation during treatment with alprazolam, placebo, or other active drugs. Item 3 of the Hamilton Rating Scale for Depression was used to evaluate these events. Neither the risk of emergence nor the risk of worsening of suicidal ideation was significantly different for alprazolam than for placebo; however, alprazolam was significantly superior to placebo in producing improvement of suicidal ideation. There was no significant difference between alprazolam and the active-comparator group in the risk of emergence of suicidal ideation. The risk of worsening of suicidal ideation was significantly less for the active-comparator group (the majority of patients in this group received amitriptyline or imipramine) than for alprazolam, and improvement of suicidal ideation occurred significantly more frequently in that group than in the alprazolam group. Use of alprazolam in depressed patients is not associated with any particular increased risk of suicidality.

[1] The S.H. ozone hole deepened into the mid-1990s, while the Northern Annular Mode (NAM) became more positive. Both effects have since stabilized. We investigate a possible connection with modeling experiments of a S. H. spring ozone hole, and also year-round ozone loss in both polar regions. The S.H. ozone hole results in a more positive NAM-like phase extending down to the surface. Reduced vertical stability increases S.H. tropospheric wave energy flux into the stratosphere which drives a residual circulation with relative subsidence over the Southern pole and upwelling and reduced planetary wave energy flux at Northern high latitudes. The results suggest that similar trends in the Southern Ozone hole and the NAM over the last 20 years may be more than just a coincidence, although other factors undoubtedly influence the Northern high latitude circulation.

[1] The intensity of moist convection is an important diagnostic of climate change not currently predicted by most climate models. We show that a simple estimate of the vertical velocity of convective updrafts in a global climate model reproduces observed land-ocean differences in convective intensity. Changes in convective intensity in a doubled CO2 simulation are small because the tropical lapse rate tends to follow a moist adiabatic profile. However, updrafts strengthen by ∼1 m s−1 with warming in the lightning-producing regions of continental convective storms, primarily due to an upward shift in the freezing level. For the western United States, drying in the warmer climate reduces the frequency of lightning-producing storms that initiate forest fires, but the strongest storms occur 26% more often. For the central-eastern United States, stronger updrafts combined with weaker wind shear suggest little change in severe storm occurrence with warming, but the most severe storms occur more often.

We investigate the issue of "dangerous human-made interference with climate" using simulations with GISS modelE driven by measured or estimated forcings for 1880-2003 and extended to 2100 for IPCC greenhouse gas scenarios as well as the 'alternative' scenario of Hansen and Sato. Identification of 'dangerous' effects is partly subjective, but we find evidence that added global warming of more than 1 degree C above the level in 2000 has effects that may be highly disruptive. The alternative scenario, with peak added forcing ~1.5 W/m2 in 2100, keeps further global warming under 1 degree C if climate sensitivity is \~3 degrees C or less for doubled CO2. We discuss three specific sub-global topics: Arctic climate change, tropical storm intensification, and ice sheet stability. Growth of non-CO2 forcings has slowed in recent years, but CO2 emissions are now surging well above the alternative scenario. Prompt actions to slow CO2 emissions and decrease non-CO2 forcings are needed to achieve the low forcing of the alternative scenario., Comment: 21 pages; 10 figures; to be submitted to Atmospheric Chemistry and Physics

We carry out climate simulations for 1880-2003 with GISS modelE driven by ten measured or estimated climate forcings. An ensemble of climate model runs is carried out for each forcing acting individually and for all forcing mechanisms acting together. We compare side-by-side simulated climate change for each forcing, all forcings, observations, unforced variability among model ensemble members, and, if available, observed variability. Discrepancies between observations and simulations with all forcings are due to model deficiencies, inaccurate or incomplete forcings, and imperfect observations. Although there are notable discrepancies between model and observations, the fidelity is sufficient to encourage use of the model for simulations of future climate change. By using a fixed well-documented model and accurately defining the 1880-2003 forcings, we aim to provide a benchmark against which the effect of improvements in the model, climate forcings, and observations can be tested. Principal model deficiencies include unrealistically weak tropical El Nino-like variability and a poor distribution of sea ice, with too much sea ice in the Northern Hemisphere and too little in the Southern Hemisphere. The greatest uncertainties in the forcings are the temporal and spatial variations of anthropogenic aerosols and their indirect effects on clouds., Comment: 44 pages; 19 figures; Final text accepted by Climate Dynamics

The purpose of this study was to assess the efficacy of fluvoxamine in the treatment of binge-eating disorder. Binge-eating disorder is a newly described eating disorder characterized by recurrent episodes of binge eating but without purging behaviors. Uncontrolled reports have suggested that serotonin selective reuptake inhibitors (SSRIs) may be effective in treating this disorder.Eighty-five outpatients with a DSM-IV diagnosis of binge-eating disorder were randomly assigned to receive either fluvoxamine (N=42) or placebo (N=43) in a 9-week, parallel-group, double-blind, flexible dose (50-300 mg) study at three centers. The primary outcome measures were frequency of binge eating, expressed as log ([binges/week]+1), and Clinical Global Impression (CGI) scale ratings. Secondary measures included the level of response (based on the percentage change in frequency of binges), body mass index, and Hamilton Rating Scale for Depression score. Except for the level of response, the outcome measures were analyzed by random regression methods; the treatment-by-time interaction was the measure of treatment effect.Compared with placebo, fluvoxamine was associated with a significantly greater rate of reduction in the frequency of binges, rate of reduction in CGI severity scores, rate of increase in CGI improvement scores, level of response for patients who completed the 9-week study, and rate of reduction in body mass index. There was no significant difference between placebo and fluvoxamine groups in the rate of decrease in Hamilton depression scale scores. A significantly greater proportion of patients receiving fluvoxamine than those receiving placebo discontinued treatment because of an adverse medical event.In this placebo-controlled trial, fluvoxamine was found to be effective according to most outcome measures in the acute treatment of binge-eating disorder.

Clinicians working with patients presenting eating disorders have long noticed that certain behaviors of this population resemble behaviors observed among substance-abusers. These behaviors involve the way in which individuals with eating disorders approach food and dieting. Some of the most common similarities between eating-disordered individuals and substance-abusers include the following: apparent loss of control over eating and related activities; a preoccupation with food, dieting, and purging; an apparent use of food to cope with stress; use of food and purging in secret; and, presence of adverse social consequences from patterns of eating, dieting, and purging.

The regulation of ingestion is an area of increasing interest to both basic scientists and clinicians. At this time, it appears that several aminergic and peptidergic neurotransmitter systems may play a salient role in regulating appetite and body weight in humans. In “pathological appetitive states,” such as bulimia and obesity, endogenous opioids (Chapter 5) and serotonin in particular may be of great importance. In this chapter, clinical data pertaining to the efficacy of opioid-blockade in the treatment of bulimia, the binge-purge syndrome (Chapter 2), are reviewed.

SummaryThe 420 first-degree relatives of 14 patients with anorexia nervosa, 55 patients with bulimia, and 20 patients with both disorders were evaluated for the presence of psychiatric illness, using DSM-III criteria, by the family history method. The morbid risk for affective disorder in the families of the eating disorder probands was similar to that found in the families of patients with bipolar disorder; but was significantly greater than that found in the families of patients with schizophrenia or borderline personality disorder. These results add to the growing evidence that anorexia nervosa and bulimia are closely related to affective disorder.

Several psychiatric conditions—conversion disorder, somatization disorder, factitious disorder, and malingering—are characterized by medical or psychiatric symptoms that are not “real” in that they lack a demonstrable biologic basis. In addition, these disorders share many other features in common, particularly when one corrects for a possible gender bias in diagnosis. We therefore offer the hypothesis that these “dissimulating disorders” may be closely related, and might be fruitfully studied as a group.

Eating disorders and substance abuse may occur together frequently. Studies have demonstrated that 25%-50% of individuals with anorexia nervosa and bulimia will have a history of substance abuse, and that certain groups of drug abusers may have elevated rates of eating disorders. One mechanism which may explain this relationship is the role of endogenous opiate peptides in triggering the compulsion to binge-eat. The authors report the successful use of the long-acting opiate antagonist naltrexone in treating a group of bulimic individuals, and discuss the implications of these findings.

Measurements of basal body temperature obtained from first-morning voided urine were followed longitudinally in 23 individuals with anorexia nervosa. In each of 10 hypothermic individuals, we found that basal body temperature was significantly correlated with weight gain, whereas in most normothermic individuals, no relationship was found. This suggests that measurement of basal body temperature may provide a convenient means of assessing clinical improvement and nutritional rehabilitation in some patients with anorexia nervosa. Differences in neuroendocrine measures and weight gain were also studied. Thyroid functions did not differ significantly between groups, and no differences were found in dexamethasone suppression or in the thyrotropin-releasing hormone (TRH) stimulation test. Hypothermic individuals, however, were significantly younger and significantly more likely to gain weight in response to treatment.

Factitious psychological symptoms are defined in DSM-III as symptoms that are under the patient's voluntary control. Using specific criteria for the presence of voluntary control, the authors identified a cohort of 9 patients with factitious psychotic symptoms from among 219 patients consecutively admitted to a research ward for psychotic disorders. The phenomenology and family history of the patients suggested that they were a homogeneous group. All had similar DSM-III personality disorders, and most had a remarkably poor long-term outcome.

Bulimia, the syndrome of compulsive binge eating, is a common and often severe disorder frequently resistant to known therapies. Recent evidence suggesting a link between bulimia and affective disorder prompted the authors to perform a double-blind study of imipramine versus placebo with 22 chronically bulimic women. Imipramine was associated with a significantly reduced frequency of binge eating and with improvement on several other measures of eating behavior. On 1- to 8-month follow-up, 18 of the 20 treated subjects (90%) had responded to imipramine or a subsequent antidepressant. This finding augments the growing evidence that bulimia may be related to affective disorder.

Follow-ups for periods of up to 2 years on 20 bulimic subjects treated with antidepressants are reported. At the time last seen in follow-up, 19 (95%) of the subjects had experienced at least a partial improvement in their bulimia, and 10 (50%) had experienced a complete remission of bulimic symptoms. In addition, most subjects displayed a marked reduction in depressive symptoms. This suggests that antidepressants do not merely reduce binge eating per se, but produce a more general therapeutic effect for bulimic patients. However, these promising findings must be tempered by the fact that antidepressant treatment is not always simple and may require extensive management over the long term.

Sixteen individuals with bulimia consented to a 6-week trial of naltrexone, receiving either standard dosages of 50-100 mg each day or high dosages of 200-300 mg each day. At the end of 6 weeks, individuals in the low-dose group had no significant change in their frequency of binge eating or purging, while individuals in the high-dose group had significant reductions in both behaviors. Four individuals in the low-dose group who were crossed over to high-dose naltrexone at the end of the study went on to experience significant reductions in binge eating and purging. These findings support the potential utility of opiate blockade in treating bulimia, but suggest that dosages of naltrexone greater than those needed to block exogenous opiates may be required for therapeutic efficacy in reducing binge eating and purging.

The first-degree relatives (N = 199) of DSM-III schizophrenic probands (N = 39) were diagnosed from chart data by a rater who was blind to proband diagnosis. No cases of even "possible" schizophrenia were found. This augments the growing evidence that the genetic component in schizophrenia may be less than was formerly suspected.

Comparing 15 consecutive male bulimic patients to a female bulimic control group, the authors found no differences on demography, associated psychopathology, family history, or treatment response. In contrast to a previous report, the authors found little evidence of increased homosexuality or "sexual conflict" in these men.

The symptoms of three bipolar patients remitted after clonidine treatment. One patient presented with mixed bipolar disorder, two were manic, and all were psychotic. One patient's akathisia also appeared to respond to clonidine. Clonidine's thymoleptic effect paralleled resulting cardiovascular changes.

To test the validity of the DSM-III diagnosis of borderline personality disorder (BPD), we examined the phenomenology, family history, treatment response, and four-to-seven-year long-term outcome of a cohort of 33 patients meeting DSM-III criteria for BPD. We found that (1) BPD could be distinguished readily from DSM-III schizophrenia; (2) BPD did not appear to represent "borderline affective disorder," although many patients displayed BPD and major affective disorder concomitantly; and (3) BPD could not be distinguished on any of the indices from histrionic and antisocial personality disorders.

To assess the nature and prevalence of psychotic symptoms in borderline personality disorder, the authors reviewed the cases of 33 patients meeting DSM-III criteria for borderline personality disorder, using both "narrow" and "broad" definitions of psychosis. Only eight patients displayed psychotic symptoms meeting the "narrow" DSM-III definition; in all of these cases, the symptoms appeared to be attributable to either severe drug abuse or major affective disorder, present simultaneously with borderline personality disorder. The remaining patients displayed only "broadly defined" psychotic symptoms or symptoms that appeared to be under voluntary control. These findings weigh against the assumption that borderline personality disorder lies "on the border" of classical psychotic disorders.