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跨诊断进食障碍结局:629 例患者 30 个月随访研究。

Trans-diagnostic outcome of eating disorders: A 30-month follow-up study of 629 patients.

机构信息

Eating Disorder Centre, Regional Centre of Child- and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark.

出版信息

Eur Eat Disord Rev. 2010 Nov-Dec;18(6):453-63. doi: 10.1002/erv.1025.

Abstract

OBJECTIVE

To assess the 30-month outcome and predictors of outcome in a cohort of patients with any eating disorder (ED).

METHOD

A naturalistic design was used to determine time to remission, predictors of remission, relapse, diagnostic cross-over and mortality of 629 patients.

RESULTS

At follow-up (FU) 312 patients attended, 42% obtained full remission and 72% partial remission. No differences were found between diagnostic groups for adolescents. Adult patients with anorexia-like eating disorder not otherwise specified-anorexia nervosa (EDNOS-AN) had the poorest outcome. Bulimia-like EDNOS was the most frequent relapse diagnosis. Bingeing/purging behaviour predicted a poorer outcome for individuals with bulimic disorders. Desired low BMI predicted a poorer outcome for individuals with anorexia. Comorbid personality disorder was a common predictor of a worse outcome.

CONCLUSION

Adults with EDNOS-AN had the poorest prognosis. Bulimic symptoms emerged frequently during FU regardless of diagnosis. Remission rates and outcome predictors were similar to previous findings.

摘要

目的

评估任何饮食障碍(ED)患者队列的 30 个月结局及其结局预测因素。

方法

采用自然设计来确定 629 名患者的缓解时间、缓解预测因素、复发、诊断交叉和死亡率。

结果

在随访(FU)时,有 312 名患者参加,42%获得完全缓解,72%获得部分缓解。青少年不同诊断组之间无差异。非典型神经性厌食症样的进食障碍(EDNOS-AN)的成年患者预后最差。类似贪食症的 EDNOS 是最常见的复发诊断。暴食/清除行为预测贪食障碍患者的预后较差。期望低 BMI 预测厌食患者的预后较差。共病人格障碍是预后不良的常见预测因素。

结论

EDNOS-AN 的成年患者预后最差。无论诊断如何,在 FU 期间经常出现贪食症状。缓解率和结局预测因素与之前的研究结果相似。

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