Maison des adolescents, PSIGIAM, U669, INSERM, Paris, France.
Psychopathology. 2011;44(1):12-20. doi: 10.1159/000315362. Epub 2010 Oct 28.
BACKGROUND/AIMS: To empirically classify phenotypes of eating disorders (ED) using latent class analysis (LCA), and to validate this classification based on clinical outcomes.
LCA was applied to 968 inpatients. The resultant classes were validated by clinical outcomes including mortality.
A 5-class solution showed the best fit. The symptoms of latent class 1 (LC1; 26% of the sample) resembled anorexia nervosa (AN), bingeing-purging (AN-B/P) subtype; those of LC2 (23%) resembled bulimia nervosa; those of LC3 (11%) were close to AN-B/P without weight and body concerns; those of LC4 resembled restrictive anorexia nervosa (RAN) without weight and body concerns, and those of LC5 RAN. A history of hospitalization for ED was significantly more frequent for LC3 and LC4. The lowest BMI at admission were presented in LC4. LC1 showed the highest level of psychological disturbances and LC4 the lowest. LC3 and LC4 differed from LC1 and LC5 by higher percentages of treatment dropout (64.9 vs. 57.2 and 55.7 vs. 47.5%, respectively; overall p = 0.001). Survival rates tended to be different between the LC (p = 0.09).
Subgroups of AN patients with low weight and body concerns seem more severe at hospitalization and more difficult to manage, with a higher rate of treatment dropout than the 'typical' AN patients.
背景/目的：使用潜在类别分析（LCA）对饮食失调症（ED）的表型进行实证分类，并根据临床结果验证这种分类。
LCA 应用于 968 名住院患者。通过包括死亡率在内的临床结果验证所得类别。
五类别解决方案显示出最佳拟合度。潜在类别 1（LC1；样本的 26%）的症状类似于神经性厌食症（AN）、暴食-清除（AN-B/P）亚型；LC2（23%）的症状类似于神经性贪食症；LC3（11%）的症状接近于无体重和身体担忧的 AN-B/P；LC4 类似于无体重和身体担忧的限制型 AN；LC5 类似于 AN。因 ED 住院的历史在 LC3 和 LC4 中更为常见。LC4 的入院时 BMI 最低。LC1 表现出最高水平的心理障碍，LC4 则最低。LC3 和 LC4 与 LC1 和 LC5 的区别在于治疗脱落率较高（分别为 64.9%、57.2%和 55.7%、47.5%；总体 p = 0.001）。LC 之间的生存率差异有趋势（p = 0.09）。
体重和身体担忧较低的 AN 患者亚组在住院时似乎更为严重，更难治疗，治疗脱落率高于“典型”AN 患者。
