Ramacciotti Carla E, Coli Elisabetta, Bondi Emi, Burgalassi Annalisa, Massimetti Gabriele, Dell'osso Liliana
Department of Psychiatry, Pharmacology, Neurobiology and Biotechnologies, Section of Psychiatry, University of Pisa, Italy.
Int J Eat Disord. 2008 Nov;41(7):643-9. doi: 10.1002/eat.20544.
To investigate obese people with/without binge-eating Disorder (BED) in terms of shared psychopathological features pertaining to spectrum of eating disorders.
One-hundred obese adult patients with a BMI > 30 kg/m(2) referred to an Eating Disorder Unit and/or hospital weight-loss programs were administered the BED Clinical Interview, the Eating Disorder Inventory, and the Structured Clinical Interview for Anorexic-Bulimic Spectrum, Self-Report.
Twenty-seven subjects satisfied DSM-IV research criteria for current BED; compared to nonbingeing obese subjects, BED ones were characterized by greater weight-shape concerns influencing self-esteem (p = .05), overall impairment due to the overweight condition (p < .005), psychological distress leading to professional help (p < .001), dichotomous reasoning (p = .01) and secondary social phobia due to the overweight condition (p < .005). Compared to the other group, BED obese subjects scored higher at the following EDI subscales: bulimia (p < .0001), ineffectiveness (p < .01), interoceptive awareness and social insecurity (p < .05).
The results of this study highlight the role of cognitive mechanisms such as dichotomous reasoning and weight-shape concerns unduly influencing self-esteem as a hallmark of BED in obese patients, and the importance of investigating eating disorder psychopathology by adopting a dimensional perspective, rather than strictly focusing on categories when dealing with obese patients.
研究患有/未患有暴饮暴食症（BED）的肥胖人群在饮食失调谱系方面的共同精神病理学特征。
对100名体重指数（BMI）> 30 kg/m²、转至饮食失调科和/或医院减肥项目的肥胖成年患者进行了BED临床访谈、饮食失调量表测试以及厌食 - 贪食谱系结构化临床访谈（自我报告版）。
27名受试者符合当前BED的DSM-IV研究标准；与非暴饮暴食的肥胖受试者相比，患有BED的受试者具有以下特征：更关注体重和体型问题并影响自尊（p = 0.05），因超重状况导致的整体功能损害（p < 0.005），因心理困扰寻求专业帮助（p < 0.001），二分法推理（p = 0.01）以及因超重状况导致的继发性社交恐惧症（p < 0.005）。与另一组相比，患有BED的肥胖受试者在以下饮食失调量表（EDI）子量表上得分更高：贪食（p < 0.0001）、无效感（p < 0.01）、内感受性觉知和社交不安全感（p < 0.05）。
本研究结果强调了认知机制的作用，如二分法推理以及过度影响自尊的体重和体型问题，这是肥胖患者BED的标志，同时强调了在处理肥胖患者时采用维度视角来研究饮食失调精神病理学的重要性，而不是严格专注于分类。
