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The tremendous increase in interest in eating disorders, and especially in bulimia nervosa, that has occurred since the last 1970s has resulted in a large and contradictory literature about the relationships between eating disorders and addictive disorders, especially alcohol and drug abuse. At first sight, according to the differences observed between these disorders in most of their phenomenological characteristics (age, sex, socio-cultural factors), it may seem difficult to draw a parallel between them. However, studies showed that eating behavior problems, alcohol and drug abuse nowadays shared some common features in adolescents and young people. However that may be, epidemiological studies demonstrated a high prevalence of substance abuse among patients with bulimia. In anorexia nervosa, this prevalence seemed to be lower. However, significant differences have been observed between bulimic and restricting anorexics: substance abuse occurred significantly more frequently in bulimic anorexics than in restricting anorexics and this characteristic was associated with a higher prevalence of impulsive behaviors (i.e. stealing, self-mutilation and suicide attempt), laxative or diuretic use and impairments in social relationships. These clinical features are quite similar to those observed in bulimic patients with substance abuse problems. Follow-up studies also showed that substance abuse problems in anorexia nervosa were associated with the occurrence of bulimic behaviors. On the other hand, family studies reported that a high prevalence of patients with bulimia had at least one first degree relatives with substance abuse problems or an affective disorder. In anorexia nervosa, the prevalence of substance abuse or depression among the family members seemed to be higher in bulimic anorexics than in restricting anorexics.(ABSTRACT TRUNCATED AT 250 WORDS)

This study investigated platelet serotonin (5-hydroxytryptamine; 5-HT) levels and the effects of different physiological and pathological factors in 108 alcoholic patients (alcohol abuse, n = 49; alcohol dependence, n = 59) and 32 healthy control subjects. Platelet 5-HT levels were determined by a fluorescent-ortho-phthalaldehyde assay. In patients, platelet 5-HT levels during withdrawal from alcohol and after 2 weeks of abstinence were significantly lower than in control subjects. Among patients, this decrease was enhanced both in alcohol-dependent patients and in patients who were depressed during the withdrawal phase, whereas lifetime impulse control disorders (mostly found in alcohol abusers) were associated with comparatively high platelet 5-HT levels (i.e., close to control subjects' values). These results, which reflect the likely biphasic effect of alcohol ingestion upon 5-HT functioning, are consistent with the dimensional 5-HT hypothesis in psychiatric disorders.

This study investigated the platelet 5-HT levels and their changes according to different physiological and pathological factors in 30 young alcoholic patients (16 alcohol abusers and 14 alcohol-dependent subjects) and 26 healthy controls. Platelet 5-HT levels were determined by a fluorescent-ortho-phthalaldehyde assay. The mean platelet 5-HT levels obtained in patients during withdrawal and after 2 weeks of abstinence were significantly lower than in controls. Presence of positive history of impulse control disorders (ICD) influenced the mean platelet 5-HT levels in patients. These preliminary results suggest that the platelet 5-HT level decrease observed in alcohol-dependent patients mostly free from ICD and in alcohol abusers mostly affected by ICD might result from comparable neurobiological mechanisms. However, the age of onset of alcohol dependence might depend on psychological functioning features.

A 100-micrograms bolus of synthetic ovine corticotropin-releasing factor was administered intravenously to 10 nondepressed inpatients suffering from an alcohol dependence disorder. The test was performed during withdrawal and after 4 weeks of abstinence. During withdrawal, the plasma cortisol responses of alcoholic patients and 7 control subjects were similar, except for an earlier decrease of cortisol in the former group. However, after 4 weeks of abstinence, the cortisol response was significantly lower in alcoholic patients than in controls. These abnormalities observed during discontinuance of alcohol consumption may reflect adaptive mechanisms of the hypothalamic-pituitary-adrenal activity which may be previously altered by chronic alcohol intoxication.