Wentz E, Gillberg C, Gillberg I C, Råstam M
Göteborg University, Sahlgren University Hospital, Sweden.
J Child Psychol Psychiatry. 2001 Jul;42(5):613-22.
The aim of this study was to assess prospectively the long-term outcome in a representative sample of teenage-onset anorexia nervosa (AN) in respect of psychiatric disorders and overall outcome. Fifty-one AN cases, recruited by community screening, with a mean age of onset of 14 years, was contrasted with 51 matched comparison cases at a mean age of 24 years (10 years after AN onset). All 102 cases had been examined at ages 16 and 21 years. At 24 years all probands were interviewed regarding psychiatric disorders (SCID-I) and overall outcome (Morgan-Russell assessment schedule, the GAF). There were no deaths at 10-year follow-up. One in four in the AN group had a persisting eating disorder (ED), including three who still had anorexia nervosa. Lifetime diagnoses of affective disorders and obsessive-compulsive disorder were over-represented in the AN group. Outcome according to Morgan-Russell was poor in 27%, intermediate in 29%, and good in 43%. According to the GAF, half the AN group had a poor psychosocial functioning. These were subjects with either a persisting ED or lifelong problems with social interaction or obsessive-compulsive behaviour. Ten-year outcome of teenage-onset AN is favourable in the majority of cases; most individuals have recovered from their ED and have no other axis I disorder. However, half the AN group reported poor psychosocial outcome, in most cases explained by a persisting ED or chronic obsessive-compulsive behaviour/social interaction problems.
本研究的目的是前瞻性评估青少年期起病的神经性厌食症（AN）代表性样本在精神障碍和总体预后方面的长期结局。通过社区筛查招募了51例AN病例，平均起病年龄为14岁，并与51例匹配的对照病例进行对比，对照病例的平均年龄为24岁（AN起病后10年）。所有102例病例均在16岁和21岁时接受过检查。在24岁时，对所有先证者就精神障碍（SCID-I）和总体结局（摩根-拉塞尔评估量表、GAF）进行了访谈。10年随访期间无死亡病例。AN组中有四分之一的人患有持续性进食障碍（ED），其中三人仍患有神经性厌食症。情感障碍和强迫症的终生诊断在AN组中比例过高。根据摩根-拉塞尔评估量表，结局差的占27%，中等的占29%，好的占43%。根据GAF，AN组中有一半人的心理社会功能较差。这些人要么患有持续性ED，要么在社交互动或强迫行为方面存在终生问题。青少年期起病的AN在大多数病例中的10年结局是良好的；大多数个体已从ED中康复，且没有其他轴I障碍。然而，AN组中有一半人报告心理社会结局较差，在大多数情况下是由持续性ED或慢性强迫行为/社交互动问题所致。
