ANGER ATTACKS IN EATING DISORDERS

As central nervous system serotonergic dysregulation has been postulat ed to exist in both eating and aggression disorders, we hypothesized t hat anger attacks would be more common among patients with eating diso rders than among control subjects. In addition, we wanted to examine p ossible relationships between the presence of anger attacks and the ty pe or severity of the eating disorder. Subjects were 39 normal female volunteers and 132 female outpatients with anorexia nervosa, bulimia n ervosa, or both. Forty-one (31%) of the patients met criteria for ange r attacks compared with four (10%) of the control subjects. Bulimic pa tients reported the highest prevalence of anger attacks, although the difference was not statistically significant. Among bulimic patients, there was a trend for anger attacks to be associated with greater seve rity of illness. In addition, patients with eating disorders who have anger attacks had significantly more depressive symptoms than patients without these attacks. Central serotonergic function is involved in s uch diverse processes as feeding behavior, mood regulation, and anger and aggression. The higher prevalence of anger attacks among patients than among control subjects may reflect central hyposerotonergic funct ion, found in previous studies to be present in both eating disorders and pathologic aggression. Supporting this interpretation is the findi ng that the prevalence of anger attacks increased, although nonsignifi cantly, with the severity of bulimia, which has previously been shown to be inversely correlated with central serotonergic activity.