Martínez-González Miguel Angel, Gual Pilar, Lahortiga Francisca, Alonso Yolanda, de Irala-Estévez Jokin, Cervera Salvador
Department of Epidemiology and Public Health, Medical School, University of Navarra, Pamplona, Spain.
Pediatrics. 2003 Feb;111(2):315-20. doi: 10.1542/peds.111.2.315.
To identify risk factors for eating disorders.
A community cohort study was conducted in Navarra, Spain. A region-wide representative sample of 2862 girls who were 12 to 21 years of age completed the Eating Attitudes Test (40-item version) and other questionnaires in 1997. Girls who scored high in the Eating Attitudes Test-40 were interviewed by a psychiatrist who applied Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria to diagnose prevalent cases of eating disorders. Girls who were free of any eating disorder in 1997 were reassessed after 18 months of follow-up using the same methods.
Ninety new cases of eating disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria were identified during the follow-up. In the multivariate logistic analysis, a higher risk of incident eating disorder was found for several exposures assessed at the beginning of follow-up, such as younger age, usually eating alone (odds ratio [OR]: 2.9; 95% confidence interval: 1.9-4.6), and frequently reading girls' magazines or listening to radio programs (OR: 2.1; 1.2-3.8 for those most frequently using both media). No independent association was found for television viewing or socioeconomic status. A marital status of parents different from "being married" was associated with a significantly higher risk in the multivariate analysis (OR: 2.0; 1.1-3.5).
Our results support the role of mass media influences and parental marital status in the onset of eating disorders. The habit of eating alone should be considered as a warning sign of eating disorders.
确定饮食失调的风险因素。
在西班牙纳瓦拉进行了一项社区队列研究。1997年，一个涵盖该地区的、具有代表性的由2862名12至21岁女孩组成的样本完成了饮食态度测试（40项版本）及其他问卷。饮食态度测试-40得分高的女孩由一名精神科医生进行访谈，该医生应用《精神疾病诊断与统计手册》第四版标准来诊断饮食失调的普遍病例。1997年未患任何饮食失调症的女孩在随访18个月后使用相同方法重新进行评估。
在随访期间，根据《精神疾病诊断与统计手册》第四版标准确定了90例新的饮食失调病例。在多变量逻辑分析中，发现随访开始时评估的几种暴露因素会增加饮食失调发病的风险，如年龄较小、通常独自进食（比值比[OR]：2.9；95%置信区间：1.9 - 4.6），以及频繁阅读少女杂志或收听广播节目（对于最常同时使用这两种媒体的人，OR：2.1；1.2 - 3.8）。未发现看电视或社会经济地位有独立关联。在多变量分析中，父母婚姻状况不同于“已婚”与显著更高的风险相关（OR：2.0；1.1 - 3.5）。
我们的结果支持大众媒体影响及父母婚姻状况在饮食失调发病中的作用。独自进食的习惯应被视为饮食失调的一个警示信号。
