Fisher M, Schneider M, Burns J, Symons H, Mandel F S
Division of Adolescent Medicine, North Shore University Hospital, Manhasset, New York 11030, USA.
J Adolesc Health. 2001 Mar;28(3):222-7. doi: 10.1016/s1054-139x(00)00182-8.
To describe differences between adolescents and adults in clinical presentation of eating disorders.
Data from the charts of 622 female patients treated for an eating disorder in a division of adolescent medicine between 1980 and 1994 were coded and computerized. General categories included demographic and family factors, weight loss and weight changes, eating-related behaviors, diagnosis and severity, and treatment issues. Differences between the 438 patients who were aged 9-19 years (adolescents) and 184 patients who were aged 20-46 years (adults) were analyzed.
Adolescents were more likely than adults (p <.05) to have a diagnosis of "eating disorder not otherwise specified," lower global severity score, greater denial and less desire for help, weight loss > or = 3 lb/month, lower original and maximum weights, and history of fasting and elimination of junk food from their diets. Adults were more likely than adolescents (p <.05) to have >1 year of weight loss, greater total weight loss, history of binge eating and laxative use, history of diuretic and ipecac use, diagnosis of bulimia nervosa, and prior use of psychiatric medications. Adolescents and adults did not differ (p >.05) in parents' occupational level; height, weight, and percent ideal body weight at presentation; original percent ideal body weight; use of diet pills, elimination of meat and use of a low-fat diet; daily calorie intake; prior eating disorder hospitalizations; and hospitalization during the course of treatment.
The findings in this study document and confirm that there are important differences between adolescents and adults that must be taken into account in the evaluation and treatment of patients with eating disorders.
描述青少年与成年人在饮食失调临床表现方面的差异。
对1980年至1994年间在青少年医学科接受饮食失调治疗的622名女性患者的病历数据进行编码和计算机处理。一般类别包括人口统计学和家庭因素、体重减轻和体重变化、饮食相关行为、诊断和严重程度以及治疗问题。分析了438名9至19岁患者（青少年）和184名20至46岁患者（成年人）之间的差异。
青少年比成年人更有可能（p<.05）被诊断为“未另行指定的饮食失调”，总体严重程度得分更低，否认程度更高且求助意愿更低，体重减轻≥3磅/月，初始体重和最高体重更低，以及有禁食和从饮食中剔除垃圾食品的病史。成年人比青少年更有可能（p<.05）体重减轻超过1年，总体体重减轻更多，有暴饮暴食和使用泻药的病史，有利尿剂和吐根糖浆使用史，被诊断为神经性贪食症，以及先前使用过精神科药物。青少年和成年人在父母职业水平、就诊时的身高、体重和理想体重百分比、初始理想体重百分比、使用减肥药、不吃肉类和采用低脂饮食、每日卡路里摄入量、先前因饮食失调住院以及治疗期间住院方面没有差异（p>.05）。
本研究结果记录并证实，青少年与成年人之间存在重要差异，在评估和治疗饮食失调患者时必须予以考虑。
