Jiménez-Murcia Susana, Fernández-Aranda Fernando, Raich Rosa M, Alonso Pino, Krug Isabel, Jaurrieta Nuria, Alvarez-Moya Eva, Labad Javier, Menchón Jose M, Vallejo Julio
Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.
Psychiatry Clin Neurosci. 2007 Aug;61(4):385-91. doi: 10.1111/j.1440-1819.2007.01673.x.
The aim of the present study was to determine whether anorexia nervosa (AN), bulimia nervosa (BN) and obsessive-compulsive disorder (OCD) share clinical and psychopathological traits. The sample consisted of 90 female patients (30 OCD; 30 AN; 30 BN), who had been consecutively referred to the Department of Psychiatry, University Hospital of Bellvitge, Barcelona. All subjects met DSM-IV criteria for those pathologies. The assessment consisted of the Maudsley Obsessive-Compulsive Inventory (MOCI), Questionnaire of obsessive traits and personality by Vallejo, Eating Attitudes Test-40 (EAT-40), Eating Disorder Inventory (EDI), and Beck Depression Inventory (BDI). ANCOVA tests (adjusted for age and body mass index) and multiple linear regression models based on obsessive-compulsiveness, obsessive personality traits and perfectionism, as independent variables, were applied to determine the best predictors of eating disorder severity. On ancova several significant differences were found between obsessive-compulsive and eating-disordered patients (MOCI, P < 0.001; EAT, P < 0.001; EDI, P < 0.001), whereas some obsessive personality traits were not eating disorder specific. A total of 16.7% OCD patients presented a comorbid eating disorder, whereas 3.3% eating disorders patients had an OCD diagnosis. In the eating disorder group, the presence of OC symptomatology was positively associated (r = 0.57, P < 0.001) with the severity of the eating disorder. The results were maintained after adjusting for comorbidity. Although some obsessive-compulsive and eating disorder patients share common traits (e.g. some personality traits especially between OCD and AN), both disorders seem to be clinically and psychopathologically different.
本研究的目的是确定神经性厌食症（AN）、神经性贪食症（BN）和强迫症（OCD）是否具有共同的临床和精神病理学特征。样本包括90名女性患者（30名强迫症患者；30名神经性厌食症患者；30名神经性贪食症患者），她们均被连续转诊至巴塞罗那贝尔维特大学医院精神科。所有受试者均符合这些病症的《精神疾病诊断与统计手册》第四版（DSM-IV）标准。评估包括莫兹利强迫症量表（MOCI）、瓦列霍强迫症特质与人格问卷、饮食态度测试-40（EAT-40）、饮食失调量表（EDI）和贝克抑郁量表（BDI）。应用协方差分析（ANCOVA）测试（对年龄和体重指数进行调整）以及基于强迫性、强迫型人格特质和完美主义作为自变量的多元线性回归模型，以确定饮食失调严重程度的最佳预测因素。在协方差分析中，发现强迫症患者和饮食失调患者之间存在若干显著差异（MOCI，P < 0.001；EAT，P < 0.001；EDI，P < 0.001），而一些强迫型人格特质并非饮食失调所特有。共有16.7%的强迫症患者患有共病性饮食失调，而3.3%的饮食失调患者被诊断患有强迫症。在饮食失调组中，强迫症状的存在与饮食失调的严重程度呈正相关（r = 0.57，P < 0.001）。在对共病进行调整后，结果依然成立。尽管一些强迫症患者和饮食失调患者具有共同特征（例如某些人格特质，尤其是强迫症和神经性厌食症之间），但这两种疾病在临床和精神病理学上似乎有所不同。
