SEROTONIN ACTIVITY IN ANOREXIA-NERVOSA AFTER LONG-TERM WEIGHT RESTORATION - RESPONSE TO D-FENFLURAMINE CHALLENGE

Abnormalities in central serotonin function have been implicated in th e pathogenesis of anorexia nervosa. It is difficult, however, to separ ate neuroendocrine abnormalities induced by weight loss and malnutriti on from those related primarily to the disorder itself. To minimize th ese influences, this study assessed long-term weight restored anorexic s. A correlation between persistent eating-related psychopathology, co -morbid illness and serotonin dysfunction was sought. Nine female weig ht-restored out-patients who had previously fulfilled DSM-III-R criter ia for anorexia nervosa and nine healthy controls participated. Follow ing baseline estimation, prolactin and cortisol responses to 30 mg p.o . of D-fenfluramine were measured over a 5 h period. Eating related ps ychopathology was assessed using the Eating Disorders Inventory and Ea ting Attitudes Test. Depressive and obsessional symptoms were measured using the Beck Depressive and Maudsley Obsessive-Compulsive Inventori es respectively. The Tridimensional Personality Questionnaire assessed impulsivity. The weight-restored anorexic group exhibited persistent eating-related psychopathology and significant co-morbid symptomatolog y. There was no difference between long-term weight restored anorexics and controls in their endocrine response to D-fenfluramine. Long-term weight-recovered anorexic subjects continued to exhibit behavioural a nd attitudinal disturbances characteristic of anorexia nervosa. The re sults suggest that abnormalities in 5HT activity do not contribute sig nificantly to trait status in anorexia nervosa.