Bulimia research
Hypnotherapy
& Bulimia
Hypnotherapy and cognitive-behavioral
therapies are commonly used to help treat bulimia nervosa, the eating
disorder, and may achieve quicker results than the more traditional
therapies, according to Australian researchers.
78 bulimia patients
participated in the study which took place over eight weeks. Their results
were compared with those on a waiting list who had not received any
treatment at all.
The two treatments were
found to be equally beneficial, and the data showed significant
improvements in the participants in the treatment groups which were not
seen in the patients who were on the waiting list and had received no
treatment of any kind.
Both the hypnotherapy and
the cognitive behavioral groups had similar low levels of bingeing or
purging after the treatment ended. Interestingly, the effects were similar
to those achieved by therapeutic approaches, which usually take much
longer.
Griffiths RA, et al. Eur
Eating Disord Rv, 1994; 2:202-20
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Light
Therapy & Bulimia
One study in Toronto (4) involving thirty-five bulimia
nervosa (BN) patients revealed that seasonal variations do exist in the
occurence and severity of BN to the point where the researchers suggested
that “seasonality may be an important dimension to consider in patients
with BN”.
The Japanese and South African
experience: - Most prevalence studies of seasonal changes in mood and
behavior have come from Western countries, however a report earlier this
year(5) revealed that the same findings occur in Japan.
Researchers at the Department of
Hygiene, Nagoya University School of Medicine, Japan administered a Japanese
translation of the Seasonal Pattern Assessment Questionnaire to 1,276 civil
servants in Nagoya, Japan. Analysis of the data revealed that the estimated
prevalence of winter seasonal affective disorder was 0.86%. The report
concluded that seasonal changes in mood and behavior do occur in Japan, but
at a lower frequency and with a different profile than in the United States
or Europe.
Similar findings proving the effect of
changes in natural daylight hours were found in studies in South Africa(6)
and Germany (7). However, the exact reason why some people are prone to
seasonal affective disorder and others are not remains unclear. Studies have
been done relating to vitamin B12 (8) and vitamin D(9), but with no
conclusive results. All that is known is that women seem to be four times
more susceptible to seasonal affective disorder than men and that serum
levels of melatonin and serotonin are also related to the prevalence of the
problem.
The answer - light treatment: - A
study at the Brigham and Women's Hospital, Boston, Massachusetts, USA (11)
in which 293 SAD patients were monitored for a variety of mood disorders
found that most patients (80%) complained of winter hypersomnia (excessive
sleep), a small percentage (10%) complained of insomnia , 5% suffered from
both hypersomnia and insomnia, and only 5% experienced no sleep difficulty.
(It should be noted though that increased sleep length in fall/winter is not
unique to SAD sufferers. Among 1571 individuals across four latitudes
surveyed at random from the general population, winter sleep increases of by
an average of 2 hours/day relative to summer.)
However, the sleep complaints
experienced by SAD patients have been accompanied by other other symptoms in
sleep patterns (ie. decreased sleep efficiency, decreased delta sleep
percentage, and increased rapid eye movement [REM] density) which are not
seen in the general population. The study also found that these problems can
be reversed by summer or by bright-light therapy. The light must, however,
be at least 2,500 lux; normal indoor light bulbs are about 400 lux and have
no therapeutic effect.
Numerous other studies (12) have come
to the same conclusion and one of the most recent investigations found that
the timing of the light treatment (ie. morning, afternoon or evening) does
not greatly influence the therapeutic outcome and furthermore that no side
effects were associated with the treatment. Studying the effect of a four
day course of half hour sessions involving 10,000-lux light treatment on
sixty eight patients, the researchers found that:-
(i) 69% of those patients who received
the treatment in the morning,
(ii) 57% of those patients who received treatment in the afternoon and
(iii)80% of those patients who received the light treatment in the evening
experienced complete relief from related symptoms.
(1)
Tietjen GH; Kripke DF. Suicides in California (1968-1977): absence of
seasonality in Los Angeles and Sacramento counties. University of
California, San Diego, La Jolla 92093-0667. Psychiatry Res (IRELAND) Aug
1994, 53 (2) p161-72
(2) Thalen BE; Kjellman BF; Morkrid L; Wibom R; Wetterberg L Light treatment
in seasonal and nonseasonal depression. Karolinska Institute, Department of
Psychiatry, St. Goran's Hospital, Stockholm, Sweden. Acta Psychiatr Scand
(DENMARK) May 1995, 91 :5, p352-60
(3) Gallagher RM; Marbach JJ; Raphael KG; Handte J; Dohrenwend BP Myofascial
face pain: seasonal variability in pain intensity and demoralization. Pain
Center, University Hospital, State University of New York at Stony
Brook11794, USA. Pain (NETHERLANDS) Apr 1995, 61 (1) p113-20
(4)Levitan RD; Kaplan AS; Levitt AJ; Joffe RT Seasonal fluctuations in mood
and eating behavior in bulimia nervosa. Department of Psychiatry, University
of Toronto, Ontario, Canada. Int J Eat Disord (UNITED STATES) Nov 1994, 16
(3) p295-9
(5) Ozaki N; Ono Y; Ito A; Rosenthal NE Prevalence of seasonal difficulties
in mood and behavior among Japanese civil servants. Department of Hygiene,
Nagoya University School of Medicine, Japan. Am J Psychiatry (UNITED STATES)
Aug 1995, 152 (8) p1225-7
(6) Szabo CP; Blanche MJ. Seasonal variation in mood disorder presentation:
further evidence of this phenomenon in a South African sample. Department of
Psychiatry, University of the Witwatersrand, Johannesburg, South Africa. J
Affect Disord (NETHERLANDS) Apr 4 1995, 33 (4) p209-14
(7) Kasper S; Ruhrmann S; Haase T; Moller HJEvidence for a seasonal form of
recurrent brief depression (RBD-seasonal).Department of Psychiatry,
University of Vienna, Austria. Eur Arch Psychiatry Clin Neurosci (GERMANY)
1994, 244 (4) p205-10
(8) Oren DA; Teicher MH; Schwartz PJ; Glod C; Turner EH; Ito YN; Sedway J;
Rosenthal NE; Wehr TA. A controlled trial of cyanocobalamin (vitamin B12) in
the treatment of winter seasonal affective disorder. National Institute of
Mental Health, Bethesda, MD 20892-0010. J Affect Disord (NETHERLANDS) Nov
1994, 32 (3) p197-200
(9)Oren DA; Schulkin J; Rosenthal NE 1,25 (OH)2 vitamin D3 levels in
seasonal affective disorder: effects of light. Clinical Psychobiology,
Branch, National Institute of Mental Health, Bethesda, MD 20892-1390.
Psychopharmacology (Berl) (GERMANY) Dec 1994, 116 (4) p515-6
(10) Danilenko KV; Putilov AA; Russkikh GS; Duffy LK; Ebbesson SO Diurnal
and seasonal variations of melatonin and serotonin in women with seasonal
affective disorder. Institute of Physiology, Russian Academy of Medical
Science, Novosibirsk. Arctic Med Res (FINLAND) Jul 1994, 53 (3) p137-45
(11) Anderson JL; Rosen LN; Mendelson WB; Jacobsen FM; Skwerer RG;
Joseph-Vanderpool JR; Duncan CC; Wehr TA; Rosenthal NE. Sleep in fall/winter
seasonal affective disorder: effects of light and changing seasons. Brigham
and Women's Hospital, Boston, Massachusetts. J Psychosom Res (ENGLAND) May
1994, 38 (4) p323-37
(12) Meesters Y; Jansen JH; Beersma DG; Bouhuys AL; van den Hoofdakker
RHLight therapy for seasonal affective disorder. The effects of timing.
Academic Hospital Groningen, The Netherlands. Br J Psychiatry (ENGLAND) May
1995, 166 (5) p607-12
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Massage
Therapy & Bulimia
Twenty-four
female adolescent bulimic inpatients were randomly assigned to a massage therapy or a
standard treatment (control) group. Results indicated that the
massaged patients showed immediate reductions (both self-report and behavior observation) in
anxiety and depression. In addition, by the last day of
the therapy, they had lower depression scores, lower cortisol (stress)
levels, higher dopamine
levels, and showed improvement on several other psychological
and behavioral measures. These findings suggest that massage therapy
is effective as an adjunct treatment for bulimia.
Adolescence 1998
Fall;33(131):555-63 Field T, Schanberg S, Kuhn C, Field T, Fierro K,
Henteleff T, Mueller C, Yando R, Shaw S, Burman I Touch Research
Institute, University of Miami School of Medicine, Florida 33101, USA.
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Guided
Imagery & Bulimia
BACKGROUND:
The objective of this study was to test a guided imagery therapy
designed to enhance self-comforting in bulimia nervosa.
METHODS: A randomized controlled trial compared 6 weeks of individual
guided imagery therapy with a control group. Fifty participants who met
DSM-III-R criteria for bulimia nervosa completed the study. Measures of
eating disorder symptoms, psychological functioning and the experience
of guided imagery therapy were administered.
RESULTS: The guided imagery treatment had substantial effects on the
reduction of bingeing and purging episodes; the imagery group had a mean
reduction of binges of 74% and of vomiting of 73%. The imagery treatment
also demonstrated improvement on measures of attitudes concerning
eating, dieting and body weight in comparison to the control group. In
addition, the guided imagery demonstrated improvement on psychological
measures of aloneness and the ability for self-comforting.
CONCLUSIONS: Evidence from this study suggests that guided imagery was
an effective treatment for bulimia nervosa, at least in the short-term.
Psychol Med 1998
Nov;28(6):1347-57 Esplen MJ, Garfinkel PE, Olmsted M, Gallop RM, Kennedy
S Department of Psychiatry/Samuel Lunefeld Research Institute, Mount
Sinai Hospital, Toronto, Ontario, Canada.
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