Vaz F J, García-Herráiz A, López-Vinuesa B, Monge M, Fernández-Gil M A, Guisado J A
Unidad de Trastornos de la Alimentación, Consejería de Sanidad y Consumo, Facultad de Medicina, Universidad de Extremadura, Badajoz, España.
Nutr Hosp. 2003 Sep-Oct;18(5):253-8.
The aim of the study was to investigate whether the use of purgative methods in patients with eating disorders (anorexia nervosa [AN] and bulimia nervosa [BN]) could be capable of producing changes in the nutritional status of the patients.
The group under study was composed of 184 female eating disordered outpatients. One hundred and sixteen patients (63.0%) fulfilled the DSM-IV diagnostic criteria for BN (90 purging type, 26 nonpurging type). Sixty eight patients (37.0%) fulfilled the DSM-IV criteria for the diagnosis of AN (48 restricting type, 20 binging-purging type).
The assessment process included anthropometry (body circumferences and skinfold thickness) and body impedance analysis.
The two subgroups of AN patients significantly differed from each of the BN subgroups. From a nutritional point of view, some significant differences between the two DSM-IV subtypes of AN existed, but not between the purging type and the nonpurging type of BN.
The paper discusses the clinical significance of these findings. An alternative subtypification of AN patients is proposed: 1) restricting type [patients who control their food intake and do not purge]; 2) purging type [patient with true episodes of binging which are followed by purgative behaviors]; and 3) pseudopurging type [patients with subjective binging episodes who use purging methods].
本研究旨在调查饮食失调（神经性厌食症[AN]和神经性贪食症[BN]）患者使用泻药方法是否能够改变患者的营养状况。
研究组由184名患有饮食失调的女性门诊患者组成。116名患者（63.0%）符合DSM-IV中BN的诊断标准（90名清除型，26名非清除型）。68名患者（37.0%）符合DSM-IV中AN的诊断标准（48名限制型，20名暴食-清除型）。
评估过程包括人体测量（身体周长和皮褶厚度）和身体阻抗分析。
AN患者的两个亚组与BN的每个亚组均有显著差异。从营养角度来看，AN的两种DSM-IV亚型之间存在一些显著差异，但BN的清除型和非清除型之间不存在差异。
本文讨论了这些发现的临床意义。提出了AN患者的另一种亚型分类：1）限制型[控制食物摄入量且不清除的患者]；2）清除型[有真正的暴食发作并伴有清除行为的患者]；3）假性清除型[有主观暴食发作并使用清除方法的患者]。
