Rayworth Beth B, Wise Lauren A, Harlow Bernard L
Obstetrics and Gynecology Epidemiology Center, Brigham & Women's Hospital & Harvard Medical School, Boston, Massachusetts 02115, USA.
Epidemiology. 2004 May;15(3):271-8. doi: 10.1097/01.ede.0000120047.07140.9d.
Eating disorders are one of the most common psychiatric disorders among women. Little is known about underlying causes.
To assess the association between childhood violence victimization and eating disorders, we performed a case-control study of women participating in the Harvard Study of Moods and Cycles, a population-based sample of women 36 to 44 years of age. Cases were women who met the diagnostic criteria for anorexia nervosa, bulimia nervosa, or binge-eating disorder after a structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). A self-administered questionnaire was used to assess a history of abuse as a child.
Compared with women who reported no abuse, women who reported childhood physical abuse had twice the odds of suffering from subclinical eating disorder symptoms (odds ratio [OR] = 2.0; 95% confidence interval [CI] = 1.3-3.3) or meeting DSM-IV criteria for an eating disorder (2.1; 1.1-4.2). Women who reported both physical and sexual abuse during childhood had 3 times the odds of developing eating disorder symptoms (3.0; 1.3-6.8) and nearly 4 times the odds of meeting DSM-IV criteria for an eating disorder (3.9; 1.3-11.5). These associations persisted within the subgroup of women with no depression antecedent to first onset of an eating disorder.
The present study provides additional evidence of an association between preadolescent trauma and psychiatric morbidity.
饮食失调是女性中最常见的精神疾病之一。其潜在病因鲜为人知。
为评估童年期遭受暴力与饮食失调之间的关联，我们对参与哈佛情绪与周期研究的女性进行了一项病例对照研究，该研究以36至44岁的女性为基于人群的样本。病例为在按照《精神疾病诊断与统计手册》第4版（DSM - IV）进行的结构化临床访谈后符合神经性厌食症、神经性贪食症或暴饮暴食症诊断标准的女性。使用一份自填式问卷来评估童年期受虐待史。
与报告未受虐待的女性相比，报告童年期身体虐待的女性出现亚临床饮食失调症状的几率是前者的两倍（优势比[OR] = 2.0；95%置信区间[CI] = 1.3 - 3.3），或符合DSM - IV饮食失调标准的几率是前者的两倍（2.1；1.1 - 4.2）。报告童年期同时遭受身体和性虐待的女性出现饮食失调症状的几率是前者的3倍（3.0；1.3 - 6.8），符合DSM - IV饮食失调标准的几率几乎是前者的4倍（3.9；1.3 - 11.5）。这些关联在首次出现饮食失调之前无抑郁的女性亚组中依然存在。
本研究为青春期前创伤与精神疾病发病率之间的关联提供了更多证据。
