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Neurocognitive functioning in bulimia nervosa: the role of neuroendocrine, personality and clinical aspects

Published online by Cambridge University Press:  01 July 2010

S. Galderisi ,
P. Bucci ,
A. Mucci ,
L. Bellodi ,
G. B. Cassano ,
P. Santonastaso ,
S. Erzegovesi ,
A. Favaro ,
M. Mauri  and
P. Monteleone
...Show all authors
S. Galderisi*
Affiliation:
Department of Psychiatry, University of Naples SUN, Italy
P. Bucci
Affiliation:
Department of Psychiatry, University of Naples SUN, Italy
A. Mucci
Affiliation:
Department of Psychiatry, University of Naples SUN, Italy
L. Bellodi
Affiliation:
Department of Neuropsychiatric Sciences, Vita-Salute University, Istituto Scientifico HS Raffaele, Milan, Italy
G. B. Cassano
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnology, University of Pisa, Italy
P. Santonastaso
Affiliation:
Department of Neurosciences, University of Padua, Italy
S. Erzegovesi
Affiliation:
Department of Neuropsychiatric Sciences, Vita-Salute University, Istituto Scientifico HS Raffaele, Milan, Italy
A. Favaro
Affiliation:
Department of Neurosciences, University of Padua, Italy
M. Mauri
Affiliation:
Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnology, University of Pisa, Italy
P. Monteleone
Affiliation:
Department of Psychiatry, University of Naples SUN, Italy
M. Maj
Affiliation:
Department of Psychiatry, University of Naples SUN, Italy
*
*Address for correspondence: Professor S. Galderisi, Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138Naples, Italy. (Email: sgalderi@tin.it)
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Abstract

Background

Studies investigating neurocognitive impairment in subjects with eating disorders (EDs) have reported heterogeneous patterns of impairment and, in some instances, no dysfunction. The present study aimed to define the pattern of neurocognitive impairment in a large sample of bulimia nervosa (BN) patients and to demonstrate that neuroendocrine, personality and clinical characteristics influence neurocognitive performance in BN.

Method

Attention/immediate memory, set shifting, perseveration, conditional and implicit learning were evaluated in 83 untreated female patients with BN and 77 healthy controls (HC). Cortisol and 17β-estradiol plasma levels were assessed. Cloninger's Temperament and Character Inventory – Revised (TCI-R), the Bulimic Investigation Test Edinburgh (BITE) and the Montgomery–Asberg Depression Rating Scale (MADRS) were administered.

Results

No impairment of cognitive performance was found in subjects with BN compared with HC. Cortisol and ‘Self-directedness’ were associated with better performance on conditional learning whereas 17β-estradiol had a negative influence on this domain; ‘Reward dependence’ was associated with worse performance on implicit learning; and depressive symptomatology influenced performance on the Wisconsin Card Sorting Test (WCST) negatively.

Conclusions

No cognitive impairment was found in untreated patients with BN. Neuroendocrine, personality and clinical variables do influence neurocognitive functioning and might explain discrepancies in literature findings.

Keywords

Co-morbiditycognitive functionseating disordersneuroendocrine indicesreward dependence
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 4 , April 2011 , pp. 839 - 848
Copyright
Copyright © Cambridge University Press 2010

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