Lee S, Lee A M, Ngai E, Lee D T, Wing Y K
Department of Psychiatry, Prince of Wales Hospital, Shatin, Hong Kong.
Int J Eat Disord. 2001 Mar;29(2):224-9. doi: 10.1002/1098-108x(200103)29:2<224::aid-eat1012>3.0.co;2-r.
To study the rationales for food refusal among Chinese patients with typical and atypical anorexia nervosa.
Forty-eight consecutive patients with broadly defined anorexia nervosa underwent evaluation with a self-report rationale for food refusal questionnaire, the 12-item General Health Questionnaire (GHQ-12), the 21-item Beck Depression Inventory (BDI-21), the Hamilton Depression Rating Scale (HDRS), and other clinical assessments.
Fat-phobic patients (N = 32) had a significantly higher premorbid body mass index than non-fat-phobic patients (N = 16), but they did not differ on other clinical parameters, GHQ-12, BDI-21, and HDRS scores. At clinical presentation, 3 months, and 1 year prior to presentation, fat phobia and stomach bloating were the most common rationales for food refusal among fat-phobic and non-fat-phobic patients, respectively. A total of 31% of fat-phobic patients endorsed non-fat-phobic rationales at the time of clinical presentation, whereas non-fat-phobic patients adhered to non-fat-phobic attributions more consistently.
The rationales used by anorexic patients to explain noneating are more varied than implied in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders and the ICD-10 Classification of Mental and Behavior Disorders: Clinical Descriptions and Diagnostic Guidelines. A broadened conceptualization of anorexia nervosa may enhance an understanding of patients' illness experiences and enliven research on eating disorders.
研究中国典型和非典型神经性厌食症患者食物拒绝的原因。
48例广义神经性厌食症患者接受了评估，使用了一份关于食物拒绝原因的自陈问卷、12项一般健康问卷（GHQ - 12）、21项贝克抑郁量表（BDI - 21）、汉密尔顿抑郁评定量表（HDRS）以及其他临床评估。
恐惧脂肪的患者（N = 32）病前体重指数显著高于非恐惧脂肪的患者（N = 16），但在其他临床参数、GHQ - 12、BDI - 21和HDRS评分方面并无差异。在临床表现时、就诊前3个月和就诊前1年，恐惧脂肪和胃部胀气分别是恐惧脂肪和非恐惧脂肪患者中最常见的食物拒绝原因。共有31%的恐惧脂肪患者在临床表现时认可非恐惧脂肪的原因，而非恐惧脂肪的患者更一致地坚持非恐惧脂肪的归因。
神经性厌食症患者用于解释不进食的原因比《精神障碍诊断与统计手册》第4版和《国际疾病分类第10版：精神与行为障碍分类：临床描述与诊断指南》中所暗示的更为多样。对神经性厌食症进行更广泛的概念化可能会增进对患者疾病经历的理解，并活跃对饮食失调的研究。
