Wold P N
Department of Psychiatry, Brown University, Providence, RI 02906.
J Psychiatry Neurosci. 1991 Nov;16(4):204-8.
Patients with Major Affective Disorder (MAD), Secondary Depression, Panic Disorder, and bulimia with and without MAD, were given the Eating Disorder Inventory, the Beck Depression Inventory, and the General Behavior Inventory at presentation. It was found that patients with MAD have a triad of eating disorder symptoms: a disturbance in interoceptive awareness, the sense of ineffectiveness, and a tendency toward bulimia. The data supported the concept that the sense of ineffectiveness is secondary to major depression. A disturbance in interoceptive awareness exists independently in bulimia nervosa and in MAD providing a common diathesis from which bulimia may arise given family and social pressure. Bulimics with MAD do not respond to treatment as readily as those without MAD. It is recomended that these two groups be treated separately.
患有重度情感障碍（MAD）、继发性抑郁症、惊恐障碍以及伴有或不伴有MAD的贪食症患者在就诊时接受了饮食失调量表、贝克抑郁量表和一般行为量表的测试。研究发现，患有MAD的患者有一组饮食失调症状：内感受性觉知障碍、无效感以及贪食倾向。数据支持了无效感继发于重度抑郁症这一概念。内感受性觉知障碍在神经性贪食症和MAD中独立存在，在家庭和社会压力下，它是贪食可能出现的一个共同素质。伴有MAD的贪食症患者对治疗的反应不如不伴有MAD的患者那么容易。建议将这两组患者分开治疗。
