Hong Kong Eating Disorders Center, 7A, Block E, Staff Quarters, Prince of Wales Hospital,Shatin, N.T., Hong Kong.
Transcult Psychiatry. 2012 Nov;49(5):678-95. doi: 10.1177/1363461512459487. Epub 2012 Sep 21.
Although gastrointestinal and other somatic symptoms are common in patients with anorexia nervosa (AN), and a growing cross-national literature indicates that not all anorexic patients exhibit the core diagnostic symptom of fat phobia, the relationship between somatic symptoms and anorexic illness remains unclear. Our objective was to evaluate gastrointestinal dysfunction (GD) in Chinese patients with fat phobic (FP) and nonfat phobic (NFP) anorexia nervosa. A total of 113 FP- and 28 NFP-AN outpatients underwent standardized clinical assessment and completed a new 8-item GD scale and other psychopathological measures. A majority (79.4%) of AN patients reported at least some gastrointestinal complaints on the GD scale (Cronbach's alpha = 0.78). FP-AN patients scored significantly higher than NFP-AN patients. The FP-AN with high GD group reported a higher level of specific and general psychopathology than the FP- and NFP-AN with low GD groups. Contrary to expectations, gastrointestinal symptoms were more common in FP-AN than NFP-AN patients. FP-AN with high GD was more severe than FP- and NFP-AN with low GD. The current fat phobic conceptualization of the anorexic illness may overlook its phenomenologic heterogeneity and reify a dichotomy that is inconsistent with patients' varied experience of food restriction.
尽管胃肠道和其他躯体症状在神经性厌食症（AN）患者中很常见，而且越来越多的跨国文献表明，并非所有厌食症患者都表现出对脂肪的恐惧这一核心诊断症状，但躯体症状与厌食症的关系仍不清楚。我们的目的是评估中国有和无脂肪恐惧的神经性厌食症（FP-AN 和 NFP-AN）患者的胃肠道功能障碍（GD）。共有 113 名 FP-AN 和 28 名 NFP-AN 门诊患者接受了标准化临床评估，并完成了新的 8 项 GD 量表和其他心理病理学测量。大多数（79.4%）AN 患者在 GD 量表上报告了至少一些胃肠道投诉（Cronbach's alpha=0.78）。FP-AN 患者的得分明显高于 NFP-AN 患者。FP-AN 高 GD 组报告的特定和一般心理病理学水平高于 FP-和 NFP-AN 低 GD 组。与预期相反，FP-AN 患者的胃肠道症状比 NFP-AN 患者更常见。FP-AN 高 GD 组比 FP-和 NFP-AN 低 GD 组更为严重。目前对厌食症的脂肪恐惧概念可能忽略了其现象学异质性，并将与患者对食物限制的不同体验不一致的二分法客观化。
