Agras W Stewart, Crow Scott, Mitchell James E, Halmi Katherine A, Bryson Susan
Department of Psychiatry, Stanford University School of Medicine, Stanford, California, USA.
Int J Eat Disord. 2009 Sep;42(6):565-70. doi: 10.1002/eat.20708.
To examine the course of Eating Disorder NOS (EDNOS) compared with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED).
Prospective study of 385 participants meeting DSM-IV criteria for AN, BN, BED, and EDNOS at three sites. Recruitment was from the community and specialty clinics. Participants were followed at 6-month intervals during a 4-year period using the Eating Disorder Examination as the primary assessment.
EDNOS remitted significantly more quickly that AN or BN but not BED. There were no differences between EDNOS and full ED syndromes, or the subtypes of EDNOS, in time to relapse following first remission. Only 18% of the EDNOS group had never had or did not develop another ED diagnosis during the study; however, this group did not differ from the remaining EDNOS group.
EDNOS appears to be a way station between full ED syndromes and recovery, and to a lesser extent from recovery or EDNOS status to a full ED. Implications for DSM-V are examined.
研究未特定的进食障碍(EDNOS)与神经性厌食症(AN)、神经性贪食症(BN)及暴饮暴食症(BED)相比的病程。
对三个地点符合DSM-IV标准的385名AN、BN、BED及EDNOS参与者进行前瞻性研究。参与者从社区和专科诊所招募。在4年期间,每隔6个月对参与者进行随访,主要评估采用进食障碍检查。
EDNOS的缓解速度明显快于AN或BN,但不比BED快。首次缓解后复发时间方面,EDNOS与完全进食障碍综合征或EDNOS亚型之间没有差异。在研究期间,只有18% 的EDNOS组参与者从未患过或未发展出其他进食障碍诊断;然而,该组与其余的EDNOS组没有差异。
EDNOS似乎是完全进食障碍综合征与康复之间的一个中间阶段,在较小程度上也是从康复或EDNOS状态转变为完全进食障碍的中间阶段。本文探讨了对《精神疾病诊断与统计手册》第五版(DSM-V)的意义。