神经性厌食症患儿的焦虑障碍

Klinika Psychiatrii Rozwojowej, Zaburzeń Psychotycznych i Wieku Podeszłego AM w Gdańsku.

Psychiatr Pol. 2006 Jan-Feb;40(1):83-97.

AIM

The basic aim of the study was the estimation of comorbidity of anxiety disorders (including obsessive-compulsive disorders) and anorexia nervosa. The next aim was to make out whether and what kind of influence is exerted on them by environmental (especially the family's) and children's own conditioning. A group of 30 children (the average age - 13.5 years), 27 girls and 3 boys treated for the first episode of anorexia nervosa was considered.

METHOD

Structured interview from patients as well as their parents, clinical observation, psychiatric and psychological investigation with the use of The Depression Rating Scale for Children (Elva o. Poznansky and comp.), The Hamilton Depression Rating Scale and The Children's Yale-Brown Obsessive-Compulsive Scale. Results were worked out with the help of statistical methods.

RESULTS

The comorbidity of anxiety disorders, OCD and anorexia nervosa in the considered group was frequently observed. Anxiety disorders were observed in the group of 16.7% patients in which 6.7% suffered from generalized anxiety disorders and 10% - from social phobia. According to the anamnesis - 40% of the investigated children, suffered from separation anxiety in the past, 13% - manifested social phobia and 10% - experienced generalized anxiety disorders. Together, during the whole life of those studied, anxiety disorders were observed in 40% of the children. Statistically, in the examined group, depression was significantly frequent amongst children suffering from anxiety disorders and anorexia nervosa (p<0.01). The comorbidity of OCD and anorexia nervosa appeared in 13.3% of the cases. As for intensity--in one case it was extremely severe, in another one--moderate and in two other cases--mild. In the investigated group of children OCD appeared in the restricting subtype of anorexia nervosa. All children with OCD and anorexia nervosa suffered from severe depression syndromes.

CONCLUSIONS

In the considered group of children suffering from anorexia nervosa the number of biological as well as psychological events which could predispose to anxiety disorders (including OCD) was found.

目的

本研究的基本目的是评估焦虑症（包括强迫症）与神经性厌食症的共病情况。下一个目的是弄清楚环境因素（尤其是家庭因素）和儿童自身条件对它们是否有影响以及有何种影响。研究对象为一组30名首次因神经性厌食症接受治疗的儿童（平均年龄13.5岁），其中27名女孩，3名男孩。

方法

对患者及其父母进行结构化访谈、临床观察，并使用儿童抑郁评定量表（埃尔瓦·O·波兹南斯基等人编制）、汉密尔顿抑郁评定量表和儿童耶鲁-布朗强迫症量表进行精神和心理调查。结果通过统计方法得出。

结果

在所研究的组中，焦虑症、强迫症与神经性厌食症的共病情况较为常见。16.7%的患者存在焦虑症，其中6.7%患有广泛性焦虑症，10%患有社交恐惧症。根据既往病史，40%的受调查儿童过去曾患有分离焦虑症，13%表现为社交恐惧症，10%经历过广泛性焦虑症。总体而言，在这些研究对象的一生中，40%的儿童曾出现过焦虑症。从统计学角度看，在被检查的组中，患有焦虑症和神经性厌食症的儿童中抑郁症的发生率显著更高（p<0.01）。强迫症与神经性厌食症的共病情况出现在13.3%的病例中。至于严重程度，1例极其严重，1例中度，另外2例轻度。在被调查的儿童组中，强迫症出现在神经性厌食症的限制型亚型中。所有患有强迫症和神经性厌食症的儿童都患有严重的抑郁综合征。