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Mood- and restraint-based antecedents to binge episodes in bulimia nervosa: possible influences of the serotonin system

  • HOWARD STEIGER (a1) (a2) (a3) (a4), LISE GAUVIN (a2) (a5), MARLA J. ENGELBERG (a4), N. M. K. NG YING KIN (a2) (a3), MIMI ISRAEL (a1) (a2) (a3), STEPHEN A. WONDERLICH (a6) and JODIE RICHARDSON (a1) (a2) (a4)
  • DOI:
  • Published online: 26 August 2005

Background. In bulimic syndromes, binge episodes are thought to be caused by dietary restraint and negative moods. However, as central serotonin (5-hydroxytryptamine: 5-HT) mechanisms regulate appetite and mood, the 5-HT system could be implicated in diet- and mood-based binge antecedents.

Method. We used hand-held computers to obtain repeated ‘online’ measurements of eating behaviors, moods, and self-concepts in 21 women with bulimic syndromes, and modeled 5-HT system activity with a measure of platelet [3H]paroxetine-binding density.

Results. Mood and self-concept ratings were found to be worse before binge episodes (than at other moments), and cognitive restraint was increased. After binges, mood and self-concept deteriorated further, and thoughts of dieting became more intense. Intriguingly, lower paroxetine-binding density predicted poorer mood and self-concept before a binge, larger post-binge decrements in mood and self-concept, and larger post-binge increases in dietary restraint.

Conclusions. Paroxetine binding thus seemed to reflect processes that impacted upon mood-related antecedents to binge episodes, and consequences implicating mood and dietary restraint.

Corresponding author
Eating Disorders Program, Douglas Hospital, 6875 LaSalle Blvd Montreal (Verdun), Quebec, Canada H4H 1R3. (Email:
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Preliminary results from this study were presented at the annual Academy for Eating Disorders International Conference on Eating Disorders, Orlando, Florida, 2 May 2004.
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Psychological Medicine
  • ISSN: 0033-2917
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