Korkina M V, Tsyvilko M A, Marilov V V, Kareva M A
Department of Psychiatry and Medical Psychology, Patrice Lumumba Peoples Friendship University, Moscow, Russia.
Int J Psychosom. 1992;39(1-4):35-40; discussion 40-1.
The authors describe current theoretical and clinical conceptualizations and treatment of anorexia nervosa in Russia, based on their experience in the follow-up of 800 patients. Three-quarters of the patients exhibited anorexia nervosa linked with a border-line state, and one-quarter associated with schizophrenia. Different relationships to dysmorphophobic fears were observed in the different anorexic groups. In the border-line group, follow-up study indicated that the clinical symptoms of anorexia nervosa were significantly reduced. However, the disorder preserved its connection with dysmorphophobic fears even in the remote stages of the disease, and in later stages there was an occurrence of pathological personality changes. In the second group, from the very beginning, anorexia nervosa in schizophrenia was closely connected with affective disorders, pathological body sensations, hypochondriacal complaints, and a gradual personality deterioration. As the schizophrenic defect increased, anorexia nervosa was reduced to an exhausted form of vomiting behaviour, and lost its connection with dysmorphophobic experiences.
作者基于对800名患者的随访经验,描述了俄罗斯目前对神经性厌食症的理论和临床概念及治疗方法。四分之三的患者表现出与边缘状态相关的神经性厌食症,四分之一与精神分裂症相关。在不同的厌食症群体中观察到对畸形恐惧症的不同关系。在边缘群体中,随访研究表明神经性厌食症的临床症状显著减轻。然而,即使在疾病的晚期,该障碍仍与畸形恐惧症保持联系,并且在后期会出现病理性人格改变。在第二组中,从一开始,精神分裂症中的神经性厌食症就与情感障碍、病理性身体感觉、疑病症主诉以及人格逐渐恶化密切相关。随着精神分裂症缺陷的增加,神经性厌食症演变为一种疲惫的呕吐行为形式,并失去了与畸形恐惧体验的联系。