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焦虑症和强迫型人格障碍与神经性厌食症的关联:来自一项家族研究的证据,并对疾病分类学和神经发育的影响进行讨论。

The association of anxiety disorders and obsessive compulsive personality disorder with anorexia nervosa: evidence from a family study with discussion of nosological and neurodevelopmental implications.

作者信息

Strober Michael, Freeman Roberta, Lampert Carlyn, Diamond Jane

机构信息

Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, California 90024-1759, USA.

出版信息

Int J Eat Disord. 2007 Nov;40 Suppl:S46-51. doi: 10.1002/eat.20429.

Abstract

BACKGROUND

To investigate the association of anorexia nervosa with anxiety disorders through use of a case-control family study design.

METHOD

Lifetime prevalence of anxiety disorders and obsessive compulsive personality disorder was determined among 574 first-degree relatives of 152 probands with anorexia nervosa and compared to rates observed among 647 first-degree relatives of 181 never-ill control probands.

RESULTS

Adjusting for comorbidity of the same illness in the proband, relatives of probands with anorexia nervosa, had a significantly higher prevalence of generalized anxiety, obsessive compulsive disorder, separation anxiety disorder, social phobia, panic disorder, and obsessive compulsive personality disorder compared to relatives of never-ill control probands.

CONCLUSION

Anorexia nervosa may share familial liability factors in common with various anxiety phenotypes. In suggesting that a transmitted propensity for anxiety is a key aspect of vulnerability in anorexia nervosa, the findings point to research developments in the affective neurosciences, specifically the neurocircuitry of fear and anxiety, as a heuristic framework in which to interpret aspects of premorbid temperamental anxieties and clinical symptoms.

摘要

背景

通过病例对照家庭研究设计,调查神经性厌食症与焦虑症之间的关联。

方法

确定152名神经性厌食症先证者的574名一级亲属中焦虑症和强迫型人格障碍的终生患病率,并与181名从未患病的对照先证者的647名一级亲属中观察到的患病率进行比较。

结果

在先证者中对同病共患情况进行校正后,与从未患病的对照先证者的亲属相比,神经性厌食症先证者的亲属中广泛性焦虑症、强迫症、分离焦虑症、社交恐惧症、惊恐障碍和强迫型人格障碍的患病率显著更高。

结论

神经性厌食症可能与各种焦虑表型共享家族易患因素。研究结果表明,焦虑的遗传倾向是神经性厌食症易感性的一个关键方面,这指向了情感神经科学的研究进展,特别是恐惧和焦虑的神经回路,作为一个启发式框架,用于解释病前气质性焦虑和临床症状的各个方面。

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