饮食失调中的强迫障碍

Obsessive compulsive disorders in eating disorders.

作者信息

Speranza M, Corcos M, Godart N, Loas G, Guilbaud O, Jeammet P, Flament M

机构信息

Adolescent and Young Adult Psychiatry Department, Institut Mutualiste Montsouris, 42 Bd Jourdan, 75014 Paris,

出版信息

Eat Behav. 2001 Autumn;2(3):193-207. doi: 10.1016/s1471-0153(01)00035-6.

DOI:10.1016/s1471-0153(01)00035-6

PMID:15001030

Abstract

OBJECTIVE

The aim of this study is to explore current and lifetime prevalence of obsessive compulsive disorders (OCD) in eating disorder (ED) subgroups and subtypes defined by the DSM-IV and to study the chronology of appearance of these disorders taking into account the role played by denutrition.

METHOD

Current and lifetime prevalence were investigated using the Mini International Neuropsychiatric Interview (MINI) and the Yale-Brown Obsessive Compulsive Scale in a sample of 89 DSM-IV ED patients (58 AN and 31 BN) and 89 matched controls.

RESULTS

Current and lifetime prevalence of OCD in ED was significantly higher than in general population (15.7% and 19% vs. 0% and 1.1%, P<.05). Anorexic patients presented a slightly higher current and lifetime comorbidity than bulimic patients (19% and 22.4% vs. 9.7% and 12.9%, n.s.). Purging anorexia was the diagnostic subtype, which presented the higher prevalences (29% and 43%), followed by restrictive anorexia (16%) and purging bulimia (13%). In the great majority of cases (65%), OCD diagnosis preceded ED diagnosis. Finally, OCD current prevalence and Y-BOCS scores of underweight patients were not significantly higher than normal-weight patients, suggesting that there were only limited links between denutrition and obsessionality.

摘要

目的

本研究旨在探讨由《精神疾病诊断与统计手册第四版》（DSM-IV）定义的饮食失调（ED）亚组和亚型中强迫症（OCD）的当前患病率和终生患病率，并考虑营养不良所起的作用来研究这些疾病出现的时间顺序。

方法

使用简明国际神经精神访谈（MINI）和耶鲁-布朗强迫症量表对89名DSM-IV饮食失调患者（58名神经性厌食症患者和31名神经性贪食症患者）以及89名匹配的对照者进行当前患病率和终生患病率调查。

结果

饮食失调患者中强迫症的当前患病率和终生患病率显著高于一般人群（分别为15.7%和19%，而一般人群为0%和1.1%，P<0.05）。厌食症患者的当前共病率和终生共病率略高于贪食症患者（分别为19%和22.4%，而贪食症患者为9.7%和12.9%，无统计学差异）。清除型厌食症是诊断亚型中患病率较高的（分别为29%和43%），其次是限制型厌食症（16%）和清除型贪食症（13%）。在绝大多数病例（65%）中，强迫症诊断先于饮食失调诊断。最后，体重过轻患者的强迫症当前患病率和耶鲁-布朗强迫症量表得分并不显著高于正常体重患者，这表明营养不良与强迫观念之间的联系有限。