饮食失调中的酒精使用障碍共病：一项多中心研究。

Alcohol use disorder comorbidity in eating disorders: a multicenter study.

作者信息

Bulik Cynthia M, Klump Kelly L, Thornton Laura, Kaplan Allan S, Devlin Bernie, Fichter Manfred M, Halmi Katherine A, Strober Michael, Woodside D Blake, Crow Scott, Mitchell James E, Rotondo Alessandro, Mauri Mauro, Cassano Giovanni B, Keel Pamela K, Berrettini Wade H, Kaye Walter H

机构信息

Department of Psychiatry, University of North Carolina at Chapel Hill, 27599-7160, USA.

出版信息

J Clin Psychiatry. 2004 Jul;65(7):1000-6. doi: 10.4088/jcp.v65n0718.

DOI:10.4088/jcp.v65n0718

PMID:15291691

Abstract

BACKGROUND

Eating disorders and alcohol use disorders (AUDs) commonly co-occur, although the patterns of comorbidity differ by eating disorder subtype. Our aim was to explore the nature of the co-morbid relation between AUDs and eating disorders in a large and phenotypically well-characterized group of individuals.

METHOD

We compared diagnostic and personality profiles of 97 women with lifetime anorexia nervosa only, 282 women with lifetime bulimia nervosa only, and 293 women with a lifetime history of both anorexia nervosa and bulimia nervosa or anorexia nervosa with binge eating (ANBN) (DSM-IV criteria). All individuals were participants in a multicenter study of the genetics of anorexia nervosa and bulimia nervosa. We explored pattern of onset, Axis I and II comorbidity, and personality characteristics of individuals with and without AUDs by eating disorder subtype. Personality characteristics were assessed with the Multidimensional Perfectionism Scale, the Temperament and Character Inventory, and the Barratt Impulsivity Scale.

RESULTS

Alcohol use disorders were significantly more prevalent in women with ANBN and bulimia nervosa than in women with anorexia nervosa (p =.0001). The majority of individuals reported primary onset of the eating disorder, with only one third reporting the onset of the AUD first. After eating disorder subtype was controlled for, AUDs were associated with the presence of major depressive disorder, a range of anxiety disorders, and cluster B personality disorder symptoms. In addition, individuals with AUDs presented with personality profiles marked by impulsivity and perfectionism.

CONCLUSIONS

Individuals with eating disorders and AUDs exhibit phenotypic profiles characterized by both anxious, perfectionistic traits and impulsive, dramatic dispositions. These traits mirror the pattern of control and dyscontrol seen in individuals with this comorbid profile and suggest that anxiety modulation may be related to alcohol use in this group.

摘要

背景

饮食失调和酒精使用障碍（AUDs）常常同时出现，尽管共病模式因饮食失调亚型而异。我们的目的是在一个规模大且表型特征明确的个体群体中，探索AUDs与饮食失调之间共病关系的本质。

方法

我们比较了97名仅患有终身神经性厌食症的女性、282名仅患有终身神经性贪食症的女性以及293名有终身神经性厌食症和神经性贪食症病史或神经性厌食症伴暴饮暴食（ANBN）（DSM-IV标准）的女性的诊断和人格特征。所有个体均参与了一项关于神经性厌食症和神经性贪食症遗传学的多中心研究。我们按饮食失调亚型，探讨了有无AUDs个体的发病模式、轴I和轴II共病情况以及人格特征。人格特征通过多维完美主义量表、气质和性格量表以及巴拉特冲动性量表进行评估。

结果

ANBN和神经性贪食症女性中酒精使用障碍的患病率显著高于神经性厌食症女性（p = 0.0001）。大多数个体报告饮食失调为首发，只有三分之一的个体报告AUDs首发。在控制饮食失调亚型后，AUDs与重度抑郁症、一系列焦虑症以及B类人格障碍症状的存在相关。此外，患有AUDs的个体呈现出以冲动性和完美主义为特征的人格特征。