Clinical course and short-term outcome of hospitalized adolescents with eating disorders: the success of combining adolescents and adults on an eating disorders unit.

Although significant controversy exists regarding the appropriate setting for treating adolescents with eating disorders, empirical studies have been lacking. This study aimed to evaluate, and compare with adults, the clinical course and short-term outcome of adolescents with eating disorders hospitalized on an adult eating disorders unit. One hundred forty-four consecutive inpatient admissions on a weight gain protocol (28% minors and 72% adults) completed psychometric measures and were assessed on clinical indices. No differences between minors and adults were demonstrated for weight gain per week on either inpatient or partial hospitalization admissions. Whereas inpatient length of stay was equivalent, adolescents stayed significantly longer in partial hospitalization than adults. Minors did not differ from adults on the presence of problematic eating disordered behaviors or most psychometric measures, although they had less functional interference due to their eating disorders. Results suggest that an adult eating disorders specialty program can be an appropriate and efficacious setting for adolescents.

Psychological adjustment in the children of mothers with a history of eating disorders.

In order to test the impact of mothers' eating disorders (EDs) on their children's psychological adjustment, we recruited mothers belonging to three different populations: women with eating disorders, women with depression, and normal controls. The parents responded to self-report inventories relating to psychological adjustment of the parent and child. The study found that the psychological adjustment of the children of mothers with a history of ED was not different from that of the children of mothers in the normal control group, although mothers described significant pregnancy and birth complications, parenting stress, and symptoms of clinical depression. The children of mothers with a history of depression had significantly greater psychological problems in comparison with those of the children of mothers in the other two groups. The results are interpreted in the context of the protective factors that may have buffered the effects of maternal psychopathology in children of mothers with a history of ED.

Cigarette smoking and its relationship to other substance use among eating disordered inpatients.

OBJECTIVE: The present study examines prevalence rates of tobacco, caffeine, alcohol and other substance use and abuse among eating disordered inpatients and compares smokers (regular vs occasional vs non-smokers) and eating disorder (ED) subtypes [anorexia nervosa (AN) vs bulimia nervosa (BN); restrictors vs purgers] on substance use behaviors, family history, depressive symptoms and impulsivity. METHOD: Participants were 100 ED inpatients who completed assessment upon treatment entry. RESULTS: A high incidence of regular cigarette smoking (29%) and occasional smoking (13%) was detected and associations were found with caffeine abuse, alcohol and marijuana use, family history and depression. BNs were more likely to smoke occasionally and use alcohol than ANs, while Purgers demonstrated higher caffeine and alcohol use than Restrictors. DISCUSSION: Comprehensive assessment and intervention for smoking, caffeine and other substance use among ED patients is clearly indicated.

A re-examination of the interaction of N-acetyl-L-aspartyl-L-glutamate with a subpopulation of rat brain membrane L-[3H]glutamate binding sites.

The neuropeptide, N-acetyl-L-aspartyl-L-glutamate (NAAG) has been reported to act at a subpopulation of putative quisqualate receptors on the basis of its competitive inhibition of specific binding of L-[3H]glutamate and on the basis of quisqualate-sensitive binding of [3H]NAAG radiolabeled on the glutamate moiety. Recently, a membrane-bound metallopeptidase, N-acetylated alpha-linked acidic dipeptidase (NAALADase), which cleaves NAAG to N-acetyl-aspartate (NAA) and glutamate, has been characterized and has been shown to exhibit optimal activity under incubation conditions used to measure NAAG binding sites. Accordingly, we have examined whether NAALADase mediated release of glutamate from NAAG might account for the receptor binding results. Insertion of empirically derived kinetic constants for NAALADase hydrolysis of NAAG into a theoretical model for peptide-derived glutamate inhibition of [3H]glutamate binding reveals that NAAG can appear to displace, with high affinity, a subpopulation of [3H]glutamate labeled sites, and yet have little or no intrinsic activity for these sites. Furthermore, empirical data relating time and protein concentration to NAAG displacement of [3H]glutamate binding are more consistent with a proteolytic mechanism rather than an equilibrium interaction of the peptide with membrane receptors. Coupled with recent findings attributing the Cl- -dependent glutamate binding to a sequestration phenomenon, these results demonstrate that the inferred action of NAAG at glutamate synaptic receptors through previous radioligand binding studies is probably incorrect. Furthermore, these studies offer a general caution regarding the conclusions about subpopulations of receptors drawn from receptor binding assays conducted with ligands, which may be structurally modified by enzymatic processes.

Quantitation of N-acetyl-aspartyl-glutamate in microdissected rat brain nuclei and peripheral tissues: findings with a novel liquid phase radioimmunoassay.

Antibodies were raised in rabbits against the neuropeptide N-acetyl-L-aspartyl-L-glutamate (NAAG) coupled to bovine serum albumin via a carbodiimide linkage. One of these rabbit antisera, which preferentially recognizes coupled NAAG-like immunoreactivity (LIR), has been previously used to immunocytochemically localize NAAG-LIR. We have now employed a second of these antisera, which preferentially recognizes free NAAG, to develop a competitive liquid phase radioimmunoassay (RIA). Using this assay, we were able to detect picomole amounts of NAAG in rat tissue extracts. The specificity of the assay revealed a 60-fold greater affinity of the antibody for NAAG over N-acetyl-aspartate (NAA) and greater than one million-fold specificity for NAAG over both aspartate and glutamate. High-pressure liquid chromatographic (HPLC) separation of tissue extracts yielded only two detectable peaks of NAAG-LIR in collected fractions and these co-chromatographed with NAAG and NAA. NAAG levels determined by this liquid phase RIA and by HPLC were essentially identical after correction for the presence of NAA crossreactivity. The antibody that preferentially recognizes coupled NAAG was used to immunocytochemically localize NAAG-LIR to the red nucleus, the facial nucleus, the dorsal raphe, and the locus coeruleus. To further confirm this localization of NAAG, these and other nuclei were microdissected and levels of NAAG were determined by liquid phase RIA. Nuclei which stained intensely were found to contain high levels of NAAG by RIA and between 60 and 100% of this NAAG-LIR co-chromatographed with NAAG. These results support our previous conclusion that NAAG is co-localized in noradrenergic, serotonergic and cholinergic neurons.(ABSTRACT TRUNCATED AT 250 WORDS)