Geist R, Heinmaa M, Katzman D, Stephens D
Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario.
Can J Psychiatry. 1999 May;44(4):374-8. doi: 10.1177/070674379904400408.
To compare gender-related psychopathology and psychiatric diagnoses in male and female adolescents referred to an adolescent eating disorder program.
All adolescents presenting at the Eating Disorder Program at our hospital completed the semistructured Diagnostic Interview for Children and Adolescents-Revised (DICA-R) and self-report scales, including the Children's Depression Inventory (CDI), the Brief Symptom Inventory (BSI), the Eating Disorder Inventory (EDI-2), and the Family Assessment Measure (FAM-III), during their initial assessment. The 157 subjects (21 male, 136 female) were classified into Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) eating disorder (ED) subtypes and then recombined into male and female restricters (R) and ED-related groups: showing eating-related concerns but not having a DSM-IV diagnosis. We compared the male and female restricter groups and ED-related group on 5 specific psychological dimensions to examine comorbid psychiatric diagnosis, ED-specific and nonspecific psychopathology, EDI clinical and provisional subscales, and family functioning using multivariate analyses of covariance (MANCOVAs).
Males endorsed statistically significant lower drive for thinness and body dissatisfaction than did females. However, there are no representative norms for adolescent males on these variables. The ED-related group also endorsed statistically significant lower drive for thinness and body dissatisfaction (specific ED psychopathology) than did the ED-restricter groups. The males in both groups endorsed fewer EDI items than did their female counterparts, but the differences were not statistically significant. Comorbid psychiatric diagnoses of depression and anxiety in male and female restricters were common but did not distinguish the groups.
Our results suggest that male and female adolescents with EDs are clinically similar to each other and therefore resemble adults for lack of gender-specific effects on self-reported psychopathology, family functioning, and comorbid psychiatric disorders.
比较转至青少年饮食失调项目的男性和女性青少年中与性别相关的精神病理学及精神疾病诊断情况。
所有在我院饮食失调项目就诊的青少年在初次评估时均完成了半结构化的儿童及青少年诊断访谈修订版(DICA-R)以及自我报告量表,包括儿童抑郁量表(CDI)、简明症状量表(BSI)、饮食失调量表(EDI-2)和家庭评估量表(FAM-III)。157名受试者(21名男性,136名女性)被分类为精神疾病诊断与统计手册(DSM-IV)饮食失调(ED)亚型,然后重新组合为男性和女性限制型(R)以及与ED相关的组:表现出与饮食相关的担忧但未被DSM-IV诊断。我们使用多变量协方差分析(MANCOVAs),在5个特定心理维度上比较男性和女性限制型组以及与ED相关的组,以检查共病精神疾病诊断、特定于ED和非特定于ED的精神病理学、EDI临床和临时子量表以及家庭功能。
男性在追求瘦身和身体不满方面的驱动力在统计学上显著低于女性。然而,这些变量在青少年男性中没有代表性的标准。与ED限制型组相比,与ED相关的组在追求瘦身和身体不满(特定于ED的精神病理学)方面的驱动力在统计学上也显著较低。两组中的男性认可的EDI项目比女性少,但差异无统计学意义。男性和女性限制型组中抑郁和焦虑的共病精神疾病诊断很常见,但未区分两组。
我们的结果表明,患有饮食失调症的男性和女性青少年在临床上彼此相似,因此由于对自我报告的精神病理学、家庭功能和共病精神疾病缺乏性别特异性影响,类似于成年人。