Fichter Manfred M, Quadflieg Norbert, Hedlund Susanne
Department of Psychiatry, University of Munich, Germany.
Int J Eat Disord. 2008 Nov;41(7):577-86. doi: 10.1002/eat.20539.
To present the twelve-year outcome of binge eating disorder (BED) in 68 female inpatients compared to bulimia nervosa, purging type (BN-P; N = 196).
Self and expert ratings focused on the beginning of therapy and the 12-year follow-up.
36% of BED and 28.2% of BN-P patients still received an eating disorder diagnosis at follow-up. Differences between groups were small (Eating Disorder Inventory, Structured Inventory for Anorexic and Bulimic Syndromes, Hopkins Symptom Checklist, Beck Depression Inventory). Similar predictors for BED and BN-P were identified. Psychiatric comorbidity was the predominant predictor of poor outcome in both diagnoses. Predictors for BED outcome were body dissatisfaction, sexual abuse, and impulsivity; self-injury predicted BN-P outcome.
Course, outcome, and mortality were similar for BED and BN-P. Both disorders had psychiatric comorbidity as the main predictor of outcome, and there was a diagnostic shift between BED and BN-P over time, pointing to their nosological proximity. Data are relevant for the formulation of DSM-V and ICD-11 diagnostic criteria.
呈现68例女性暴食症（BED）住院患者与196例清除型神经性贪食症（BN-P）患者的12年治疗结果。
自我评定和专家评定聚焦于治疗开始时及12年随访时。
随访时，36%的BED患者和28.2%的BN-P患者仍被诊断为饮食失调症。两组之间差异较小（饮食失调量表、神经性厌食症和神经性贪食症综合征结构化量表、霍普金斯症状清单、贝克抑郁量表）。确定了BED和BN-P的相似预测因素。精神共病是两种诊断中预后不良的主要预测因素。BED预后的预测因素是身体不满、性虐待和冲动性；自我伤害可预测BN-P的预后。
BED和BN-P的病程、结局及死亡率相似。两种疾病均以精神共病作为预后的主要预测因素，且随着时间推移BED和BN-P之间存在诊断转变，表明它们在疾病分类学上相近。这些数据与《精神疾病诊断与统计手册》第五版（DSM-V）和《国际疾病分类》第11版（ICD-11）诊断标准的制定相关。
