《精神疾病诊断与统计手册》第四版（DSM-IV）中进食障碍诊断标准在青少年中的患病率及实用性
Prevalence and utility of DSM-IV eating disorder diagnostic criteria among youth.
作者信息
Ackard Diann M, Fulkerson Jayne A, Neumark-Sztainer Dianne
出版信息
Int J Eat Disord. 2007 Jul;40(5):409-17. doi: 10.1002/eat.20389.
OBJECTIVE
To examine the prevalence and utility of DSM-IV eating disorder (ED) criteria and anorexia (AN), bulimia (BN), and binge eating disorder (BED) among adolescents.
METHOD
An ethnically diverse population-based sample of 4,746 public middle and high school students completed anthropometric measures and Project EAT survey items.
RESULTS
Many youth endorsed body shape perception disturbance (41.5% female; 24.9% male), undue influence of body shape/weight on self-esteem (36.4% female; 23.9% male), and compensatory behavior (9.4% female; 13.5% male). Prevalence among females and males, respectively, was: AN = 0.04%, 0%; BN = 0.3%, 0.2%; BED = 1.9%, 0.3%. Analyses of individual criteria showed high sensitivity and negative predictive values for each disorder and corresponding criteria, low specificity for several AN (27.8%) and BN (32.0%) criteria, and low positive predictive values (0.06-40.2%).
CONCLUSION
Body disparagement and compensatory behaviors indicate eating disturbance, despite low prevalence of EDs. Diagnostic classification may be clinically useful, but is complicated for use in epidemiological populations.
目的
研究《精神疾病诊断与统计手册》第四版（DSM-IV）中饮食失调（ED）标准以及青少年中神经性厌食症（AN）、神经性贪食症（BN）和暴饮暴食症（BED）的患病率及实用性。
方法
一项基于人群的样本，包含4746名公立初中和高中学生，他们来自不同种族，完成了人体测量指标和“饮食与健康行动计划”（Project EAT）调查问卷项目。
结果
许多青少年认可身体形状感知障碍（女性为41.5%；男性为24.9%）、身体形状/体重对自尊的过度影响（女性为36.4%；男性为23.9%）以及代偿行为（女性为9.4%；男性为13.5%）。女性和男性中的患病率分别为：神经性厌食症（AN）=0.04%，0%；神经性贪食症（BN）=0.3%，0.2%；暴饮暴食症（BED）=1.9%，0.3%。对个体标准的分析显示，每种疾病及其相应标准具有较高的敏感性和阴性预测值，几种神经性厌食症（27.8%）和神经性贪食症（32.0%）标准的特异性较低，阳性预测值也较低（0.06 - 40.2%）。
结论
尽管饮食失调的患病率较低，但身体贬低和代偿行为表明存在饮食紊乱。诊断分类在临床上可能有用，但在流行病学人群中使用较为复杂。
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