Centro per la cura dei Disturbi Del Comportamento Alimentare, Perugia, Italy.
Psychiatr Danub. 2012 Sep;24 Suppl 1:S119-24.
The origin and course of eating disorders constitute a multifactorial etiopathology. This is why it is important to consider the psychological, developmental, biological and socio - cultural evaluation of each patient. The Diagnostic and Statistical Manual DSM IV - TR (APA, 1994) distinguishes two main eating disorders: Anorexia Nervosa and Bulimia Nervosa. Together with them are described a broad and heterogeneous category (EDNOS) of "atypical eating disorders," that is a clinically significant eating disorder, but that does not meet all the diagnostic criteria for Anorexia Nervosa or Bulimia Nervosa. The aim of this pilot study was to analyze the differences detectable in anorexic and bulimic patients in relation to several factors of mental functioning, particularly with respect to the presence of distinctive characteristics and symptoms and the associated substrate personality.
20 patients with eating disorders who have a residential rehabilitation program, all women, 10 diagnosed with AN aged between 18 years and 31 years, including (5 Restrictive and 5 with Purging) and 10 diagnosed with BN aged between 19 years and 31 years (including 5 with Purging).
The pictures of AN and BN can be placed within a continuum of symptoms that distinguishes them exclusively for the presence or absence of bulimic episodes; also the symptom of bulaemia can be considered a most important aspect in the distinction between anorexia and bulimia as all other aspects of mental functioning appear to be similar in almost direct measurement, and finally some food pathological events are associated with personality characteristics, Axis I symptoms and quality of life, linked to specific types of global functioning.
Some symptoms may have different functions depending on the patient's personality style: a patient may develop a symptom of anorexia because it is competitive and a perfectionist, another as a form of self-punishment or as a strategy to regulate the feeling of being out of control, another again as a phenotypic expression of an underlying mood disorder, in the same way the purging may represent a reaction for a patient who is emotionally dysregulated or a measure of weight control which is more deliberate for a patient who is highly controlled perfectionist.
There is a need to look at eating disorders within a global view of mental functioning, these conditions may be considered "diagnostic trans', ie disturbances traveling along a continuum, and are therefore characterized by a "diagnostic migration."
饮食失调的起源和过程构成了一种多因素的病因。这就是为什么要考虑每个患者的心理、发展、生物和社会文化评估是很重要的原因。《精神疾病的诊断与统计手册》第四版 - 文本修订版（APA，1994 年）区分了两种主要的饮食失调：神经性厌食症和神经性贪食症。与之一起描述的是一个广泛而不同的类别（EDNOS）的“非典型饮食失调”，即一种临床上显著的饮食失调，但不符合神经性厌食症或神经性贪食症的所有诊断标准。本初步研究的目的是分析厌食症和贪食症患者在几个心理功能因素方面可检测到的差异，特别是与独特特征和症状的存在以及相关的人格基础有关。
20 名患有饮食失调症的患者参加了一个住院康复计划，均为女性，年龄在 18 至 31 岁之间，其中 10 名被诊断为 AN（5 名限制型和 5 名有清泻型），10 名被诊断为 BN（5 名有清泻型）。
AN 和 BN 的图像可以放置在一个区分它们的症状连续体中，仅通过是否存在或不存在暴食发作来区分；暴食的症状也可以被认为是区分厌食症和贪食症的最重要方面，因为几乎在直接测量中，所有其他心理功能方面都显得相似，最后，一些食物病理性事件与人格特征、轴 I 症状和生活质量有关，与特定类型的整体功能有关。
一些症状可能根据患者的个性风格具有不同的功能：一个患者可能会因为竞争和完美主义而出现厌食症的症状，另一个可能是作为自我惩罚的形式，或者是控制失控感的策略，另一个可能是作为潜在情绪障碍的表型表达，同样，清泻可能代表一个情绪失调的患者的反应，或者是一个高度控制完美主义的患者更刻意的体重控制措施。
需要从整体的心理功能角度来看待饮食失调，这些情况可以被视为“诊断过渡”，即沿着连续体移动的障碍，因此其特征是“诊断迁移”。
