Beumont Pierre J V, Touyz Stephen W
Dept of Psychological Medicine, Royal Prince Alfred Hospital, University of Sydney, Sydney 2006, Australia.
Eur Child Adolesc Psychiatry. 2003;12 Suppl 1:I20-4. doi: 10.1007/s00787-003-1103-y.
With the best will in the world, it is difficult not to become disillusioned with the diagnostic system for eating disorders. Although repeatedly revised, diagnostic criteria such as those of DSM-IV or ICD10 are inadequate to describe the patient's condition. This essay critically appraises the historical development of eating disorders and challenges the widely held notion that bulimia nervosa and anorexia nervosa share a common psychopathology. It further argues that the time has arrived to think about anorexia nervosa and the eating disorders in a way different to the current stereotyping. It suggests that anorexia nervosa like neoplasia is a disease that requires staging and a model for such staging is presented.
尽管怀着最美好的愿望,但很难不对饮食失调的诊断系统感到失望。尽管经过多次修订,诸如《精神疾病诊断与统计手册》第四版(DSM-IV)或国际疾病分类第十版(ICD-10)中的诊断标准仍不足以描述患者的病情。本文批判性地评估了饮食失调的历史发展,并对普遍认为的神经性贪食症和神经性厌食症具有共同精神病理学的观点提出了挑战。它进一步认为,现在是时候以一种不同于当前刻板印象的方式来思考神经性厌食症和饮食失调了。它表明,神经性厌食症就像肿瘤一样,是一种需要分期的疾病,并提出了一个这样的分期模型。