Kotler L A, Walsh B T
Division of Child Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Eur Child Adolesc Psychiatry. 2000;9 Suppl 1:I108-16. doi: 10.1007/s007870070024.
Anorexia nervosa and bulimia nervosa do exist in childhood, frequently have their onset in adolescence, and can result in serious medical and psychiatric sequelae that impede physical, emotional, and behavioral development. Although we use the same Diagnostic and Statistical Manual of Mental Disorders-Version 4 [DSM-IV] definitions to diagnose eating disorders in children, adolescents, and adults, these disorders may be expressed somewhat differently in younger populations, requiring assessment and treatment procedures that are tailored to their developmental needs. Significant advances have been made in recent years in our understanding of treatments for eating disorders in adults, and specifically pharmacological treatments for these disorders. Multiple double-blind, placebo-controlled studies have documented the short-term efficacy of antidepressant medications in bulimia nervosa. While the usefulness of pharmacological treatments for the acute treatment of anorexia nervosa is less clear, recent evidence suggests a role for medication in the relapse-prevention stage of the illness. The majority of the medication trials for the eating disorders have been conducted with adults, and the literature on the pharmacological treatment of children and adolescents with these disorders is very limited. This review article summarizes the current literature on the role of medication in the treatment of anorexia nervosa and bulimia nervosa, with particular emphasis on studies conducted in child and adolescent populations.
神经性厌食症和神经性贪食症在儿童期确实存在，常在青春期发病，并可导致严重的医学和精神后遗症，阻碍身体、情感和行为发展。尽管我们使用相同的《精神疾病诊断与统计手册（第4版）》（DSM-IV）定义来诊断儿童、青少年和成人的饮食失调，但这些疾病在较年轻人群中的表现可能略有不同，需要根据他们的发育需求制定评估和治疗程序。近年来，我们对成人饮食失调治疗方法的理解，尤其是对这些疾病的药物治疗，取得了重大进展。多项双盲、安慰剂对照研究记录了抗抑郁药物在神经性贪食症治疗中的短期疗效。虽然药物治疗对神经性厌食症急性治疗的有效性尚不清楚，但最近的证据表明药物在该疾病的预防复发阶段有一定作用。大多数饮食失调的药物试验是在成人中进行的，关于儿童和青少年饮食失调药物治疗的文献非常有限。这篇综述文章总结了目前关于药物在神经性厌食症和神经性贪食症治疗中作用的文献，特别强调了在儿童和青少年人群中进行的研究。
