Grucza Richard A, Przybeck Thomas R, Cloninger C Robert
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA.
Compr Psychiatry. 2007 Mar-Apr;48(2):124-31. doi: 10.1016/j.comppsych.2006.08.002. Epub 2006 Nov 9.
Diagnostic criteria for binge eating disorder (BED) appear in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition as "criteria for further study." Few epidemiological studies of BED have been conducted. Our aim was to describe the prevalence and correlates of BED, as assessed by the Patient Health Questionnaire (PHQ) in a community sample.
Descriptive epidemiology from a survey of 910 randomly ascertained participants residing in the greater metropolitan area of St Louis, Mo.
Sixty individuals (6.6%) screened positive for current BED, as assessed by the PHQ (BED+). Men were as likely to screen positive as women. BED+ subjects were at substantially elevated odds for depression, generalized anxiety disorder, panic attacks, and past suicide attempts; individuals with obesity who screened negative for BED (BED-) were not at elevated odds for these syndromes. BED+ subjects, but not other obese individuals, exhibited substantially lower scores on measures of mental health-related quality of life. Personality traits associated with BED symptoms included high Novelty Seeking, high Harm Avoidance, and low Self-directedness. Personality and psychiatric profiles in obese, BED- individuals were closer to those for normal-weight, BED- individuals, suggesting that BED is distinct from typical obesity. BED+ subjects reported mean body mass index of 34.1, more than 6 units above BED- subjects.
PHQ-BED criteria are associated with substantial impairment, psychiatric comorbidity, and obesity and effectively discriminate obese individuals with psychological problems from obese subjects without similar problems. BED may be considerably more prevalent than other eating disorders and equally prevalent among men and women.
暴食症(BED)的诊断标准在《精神疾病诊断与统计手册》第四版中列为“进一步研究的标准”。针对BED的流行病学研究较少。我们的目的是通过患者健康问卷(PHQ)评估社区样本中BED的患病率及相关因素。
对居住在密苏里州圣路易斯市大都市区的910名随机选定的参与者进行调查,采用描述性流行病学方法。
通过PHQ评估,60人(6.6%)当前BED筛查呈阳性(BED+)。男性和女性筛查呈阳性的可能性相同。BED+受试者患抑郁症、广泛性焦虑症、惊恐发作和既往自杀未遂的几率大幅升高;BED筛查呈阴性的肥胖个体(BED-)患这些综合征的几率并未升高。BED+受试者,但不包括其他肥胖个体,在心理健康相关生活质量测量中的得分显著较低。与BED症状相关的人格特质包括高寻求新奇、高回避伤害和低自我导向。肥胖的BED-个体的人格和精神状况更接近正常体重的BED-个体,这表明BED与典型肥胖不同。BED+受试者报告的平均体重指数为34.1,比BED-受试者高出6个多单位。
PHQ-BED标准与严重损害、精神共病和肥胖相关,能有效区分有心理问题的肥胖个体和没有类似问题的肥胖受试者。BED可能比其他饮食失调症更为普遍,在男性和女性中患病率相同。