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Salivary and gustatory alterations among bulimia nervosa patients

European Journal of Clinical Nutrition volume 62, pages 916–922 (2008)Cite this article

Abstract

Objective and design:

This study systematically examined salivary composition and taste perception and monitored related subjective complaints in a group of bulimia nervosa (BN) patients.

Subjects:

Fifty-two consenting female individuals participated in the current cross-sectional study, 26 patients diagnosed with BN according to the Diagnostic and statistical manual of mental disorders-IV (DSM-IV) criteria (mean age: 24±7 years) and 26 healthy controls matching in age and body mass index (BMI).

Methods:

All participants were given diagnostic BN-related questionnaires, had taste and salivary-composition analyses and were monitored for oral sensorial complaints. The patients were also subjected to psychological and psychiatric examinations focusing on established criteria known to be pathognomonic of the disease (including binge eating episodes, depression, impulsive traits, enhanced awareness of body image, typical compensatory behavior, and so on).

Results:

The self-answered questionnaires of bulimic investigatory test Edinburgh (BITE), Beck Depression Inventory (BDI), brief symptom inventory (BSI) and impulsivity scale (IS) revealed highly significant differences between the two groups with respect to the various BN diagnostic symptoms of the patients (P=0.0001). Subjective and objective examinations showed an overall disturbed salivary and taste profile in BN patients, who complained of xerostomia (dry mouth) and taste aberration or oral burning sensation.

Conclusions:

Regardless of the specific mechanism responsible for the disturbed salivary and taste profile in BN patients, these observed changes are associated with active illness. Accordingly, administration of therapeutic agents, including antioxidants, anti-inflammatory drugs and saliva substitutes, to the oral cavity (and maybe even systemically) of BN patients should be considered.

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References

  • American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders 4th ed. (DSM IV) APA Press: Washington, DC. pp. 539–550.

  • Avena NM, Rada P, Moise N, Hoebel BG (2006). Sucrose sham feeding on a binge schedule releases accumbens dopamine repeatedly and eliminates the acetylcholine satiety response. Neuroscience 139, 813–820.

    Article  CAS  Google Scholar 

  • Bachar E, Latzer Y, Kreitler S, Berry EM (1999). Empirical comparison of two psychological therapies. Self psychology and cognitive orientation in the treatment of anorexia and bulimia. J Psychother Prac Res 8, 115–128.

    CAS  Google Scholar 

  • Baum JB, Costa PT, Izutsu TK (1984). Sodium handling by aging human parotid glands is inconsistent with a two-stage secretion model. Amer J Physiol 246, 35–39.

    Google Scholar 

  • Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961). An inventory for measuring depression. Arch Gen Psych 4, 561–571.

    Article  CAS  Google Scholar 

  • Ben-Aryeh H, Jungerman T, Szargel R, Klein E, Laufer D (1996). Salivary flow-rate and composition in schizophrenic patients on clozapine: subjective reports and laboratory data. Biol Psychol 39, 946–949.

    Article  CAS  Google Scholar 

  • Derogatis LR, Melisaratos N (1983). The brief symptom inventory: an introductory report. Psychol Med 13, 595–605.

    Article  CAS  Google Scholar 

  • Granot M, Nagler RM (2005). Association between regional idiopathic neuropathy and salivary involvement as the possible mechanism for oral sensory complaints. J Pain 6, 581–587.

    Article  Google Scholar 

  • Hardt M, Witkiwska HE, Webb S (2005). Assessing the effects of diurnal variation on the composition of human parotid saliva: quantitative analysis of native peptides using iTRAQ reagents. Anal Chem 77, 4947–4954.

    Article  CAS  Google Scholar 

  • Henderson M, Freeman CP (1987). A self-rating scale for bulimia. The ‘BITE.’. Br J Psychiatry 150, 18–24.

    Article  CAS  Google Scholar 

  • Henkin RI (1987). Testing taste. Lancet 2, 515.

    Article  CAS  Google Scholar 

  • Kronvall P, Fahy TA, Isaksson A, Theander S, Russell GF (1992). The clinical relevance of salivary amylase monitoring in bulimia nervosa. Biol Psychiatry 32, 156–163.

    Article  CAS  Google Scholar 

  • Mancini G, Carbonara AO, Heremans JF (1965). Immunochemical quantitation of antigens by single radial immunodiffusion. Immunochemistry 2, 235–254.

    Article  CAS  Google Scholar 

  • Markley EJ, Mattes-Kulig D, Henkin RI (1983). A classification of dysgeusia. J Amer Diet Assoc 83, 578–580.

    CAS  Google Scholar 

  • Milosevic A, Dawson LJ (1996). Salivary factors in vomiting bulimics with and without pathological tooth wear. Caries Res 30, 361–366.

    Article  CAS  Google Scholar 

  • Nagler R, Klein I, Zarzhevsky N, Drigues N, Reznick AZ (2002b). Characterization of the differentiated antioxidant profile of human saliva. Free Radic Biol Med 32, 268–277.

    Article  CAS  Google Scholar 

  • Nagler RM, Hershkovich O, Lischinsky S, Diamond E, Reznick AZ (2002a). Saliva analysis in the clinical setting: revisiting an underused diagnostic tool. J Investig Med 50, 214–225.

    Article  CAS  Google Scholar 

  • Nagler RM, Lischinsky S, Diamond E, Klein I, Reznick AZ (2001). New insights into salivary lactate dehydrogenase of human subjects. J Lab Clin Med 137, 363–369.

    Article  CAS  Google Scholar 

  • Nagler R, Marmary Y, Krausz Y, Chisin R, Markitziu A, Nagler A (1996). Major salivary gland dysfunction in human acute and chronic graft-versus-host disease (GVHD). Bone Marrow Transplant 17, 219–224.

    CAS  PubMed  Google Scholar 

  • Paszynska E, Limanowska-Shaw H, Slopien A, Rajewski A (2006). Evaluation of oral health in bulimia nervosa. Psych Pol 40, 109–118.

    Google Scholar 

  • Plutchik R, Van Praag H (1989). The measurement of suicidality, aggressivity and impulsivity. Prog Neuropsychopharm Biol Psych 13 suppl), S23–S34.

    Article  Google Scholar 

  • Rauscher E, Neumann U, Schaich E, von Bulow S, Wahlenfeld AW (1985). Optimized conditions for determining activity concentration of alpha-amylase in serum, with 1,4-alpha-D-4-nitrophenylmaltoheptaoside as substrate. Clin Chem 31, 14–19.

    CAS  PubMed  Google Scholar 

  • Reznick AZ, Klein I, Eiserich JP, Cross CE, Nagler RM (2003). Inhibition of oral peroxidase activity by cigarette smoke: in vivo and in vitro studies. Free Radic Biol Med 34, 377–384.

    Article  CAS  Google Scholar 

  • Riad M, Barton JR, Wilson JA, Freeman CP, Maran AG (1991). Parotid salivary secretory pattern in bulimia nervosa. Acta Otolaryngol 111, 392–395.

    Article  CAS  Google Scholar 

  • Rodin J, Bartoshuk L, Peterson C, Schank D (1990). Bulimia and taste: possible interactions. J Abnorm Psychol 99, 32–39.

    Article  CAS  Google Scholar 

  • Rytomaa I, Jarvinen V, Kanerva R, Heinonen OP (1998). Bulimia and tooth erosion. Acta Odontol Scand 56, 36–40.

    Article  CAS  Google Scholar 

  • Scheutzel P (1996). Etiology of dental erosion – intrinsic factors. Eur J Oral Sci 104, 178–190.

    Article  CAS  Google Scholar 

  • Tylenda CA, Roberts MW, Elin RJ, Li SH, Altemus M (1991). Bulimia nervosa: its effect on salivary chemistry. J Amer Dent Assoc 122, 37–41.

    Article  CAS  Google Scholar 

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Acknowledgements

We thank Mrs S Gan for her assistance in preparing the statistical analysis of this paper.

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Authors and Affiliations

  1. Psychiatric Division, Eating Disorders Clinic, Rambam Medical Center, Haifa, Israel

    T Blazer & Y Latzer

  2. Oral and Maxillofacial Surgery Department, Biochemistry Laboratory and Salivary Clinic, Rambam Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    T Blazer & R M Nagler

  3. School of Social Work, Faculty of Social Welfare and Health Studies, University of Haifa, Israel

    Y Latzer

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  1. T Blazer
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Correspondence to R M Nagler.

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Blazer, T., Latzer, Y. & Nagler, R. Salivary and gustatory alterations among bulimia nervosa patients. Eur J Clin Nutr 62, 916–922 (2008). https://doi.org/10.1038/sj.ejcn.1602801

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