Excerpt from Annual Report, Division of Intramural Research Programs, National Institute of Mental Health, Vol. 2: October 1, 1991-September 30, 1992, Part 1, Individual Project Reports

Our data also indicate that patients with anorexia nervosa and bulimia nervosa show obsessional symptoms in the range of severity seen in patients with classic obsessive compulsive disorder. These include behaviors such as ritual cleaning, trichotillomania, and repetitive checking. Moreover, their intense preoccupation with food intake and body image can be construed as an obsessional symptom. We have previously reported in The New England Journal of Medicine that patients with anorexia nervosa show a profound disruption in the osmoregulation of plasma arginine vasopressin associated with hypersecretion of this peptide into the cerebrospinal ¿uid. In the light of the fact that cenually-directed vasopressin in experimental anim¿s delays the extinction of behaviors acquired during aversive conditioning, we postulated that the hypersecretion of vasopressin into the cns could contribute to the obsessive preoccupation that patients with anorexia nervosa have with the potential adverse consequences of eating and weight gain. In the past year, we have shown that normal weight patients with bulimia nervosa show qualitatively similar abnormalities in the osmoregulation of plasma arginine vasopressin and in the secretion of this peptide into the csp. Recently, we have shown an almost identical defect in patients with classic obsessive-compulsive disorder. These data suggest that the eating and obsessional disorders share similar pathophysiological features and that a common defect in the regulation of arginine vasopressin secretion may underlie the obsessional behaviors that are the cardinal manifestations of these illnesses.

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