Latzer Yael, Tzchisinki Orna
Eating Disorders Clinic, Psychiatric Division, Rambam Medical Center, School of Social Work, Haifa University, Haifa, Israel.
Harefuah. 2003 Jul;142(7):544-9, 564.
Binge Eating Disorder (BED) is a proposed new diagnostic criteria in the DSM-IV, cited as an example of an eating disorder Not Otherwise Specified (NOS). The phrase Binge Eating was introduced over 35 years ago to describe problematic behavior found in a subgroup of overweight individuals, and as a subgroup of Bulimia Nervosa. The defining characteristics of BED patients are consumptions of an objectively large amount of food in discrete time periods, a lack of control during eating episodes and a lack of compensatory behavior binge. BEDs affect approximately 30% of obese individuals seeking treatment. The binge eaters represent a distinct subgroup among the obese with higher prevalence of comorbid psychiatric disturbances, as well as higher rates of eating pathology, as compared to normal obese women. Several researches suggested that individuals use binge eating as a means of coping with emotional distress. In addition, the binge eating disorder represents a distinct subgroup among bulimia nervosa with lower comorbid psychiatric disturbances, eating pathology and purging behavior. The present paper will review this proposed syndrome and will discuss the question of whether it is a distinct subgroup of obese patients or a distinct subgroup of bulimia nervosa patients, or a new diagnostic category. This diagnostic dilemma is discussed in light of clinical and empirical literature. Clinical and therapeutic implications are presented and ideas for future research are proposed.
暴饮暴食症(BED)是《精神疾病诊断与统计手册》第四版(DSM-IV)中一项拟议的新诊断标准,被列为未另行规定的进食障碍(NOS)的一个示例。“暴饮暴食”这一表述在35多年前就已出现,用于描述在超重个体亚组以及神经性贪食症亚组中发现的问题行为。暴饮暴食症患者的定义特征是在离散时间段内客观上大量进食、进食期间缺乏自控以及缺乏补偿性的催吐行为。暴饮暴食症影响了约30%寻求治疗的肥胖个体。与正常肥胖女性相比,暴饮暴食者在肥胖人群中代表了一个独特的亚组,其共病精神障碍的患病率更高,进食病理学发生率也更高。多项研究表明,个体将暴饮暴食作为应对情绪困扰的一种方式。此外,暴饮暴食症在神经性贪食症患者中代表了一个独特的亚组,其共病精神障碍、进食病理学和清除行为的发生率较低。本文将对这一拟议的综合征进行综述,并讨论它是肥胖患者的一个独特亚组、神经性贪食症患者的一个独特亚组,还是一个新的诊断类别这一问题。将根据临床和实证文献来讨论这一诊断困境。阐述临床和治疗方面的意义,并提出未来研究的思路。