Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany,
Eat Weight Disord. 2013 Jun;18(2):157-65. doi: 10.1007/s40519-013-0020-4. Epub 2013 Apr 16.
This study aimed at investigating the prevalence, psychiatric comorbidity and outpatient treatment in a sample of German children and adolescents with eating disorders (EDs).
Data of a large German statutory health insurance company were analysed and outpatients aged between 10 and 21 years with an ED diagnosis in 2009 were identified.
Of 248,558 insured children and adolescents, 1,404 patients (79.9 % females, mean age: 16.7; SD: 3.3 years) matched the inclusion criteria. The large majority of patients with anorexia nervosa (AN) and bulimia nervosa (BN) were females (94.7 and 92.7 %), on which we focus in the following analyses. The prevalence in females was 0.28 % (AN) and 0.20 % (BN). Psychiatric comorbidity was diagnosed in 59.8 % (AN) and 64.1 % (BN) of patients, respectively. Most patients were treated with psychotherapy (AN: 75.7 %, BN: 78.5 %), 16.4 % (AN) and 20.2 % (BN) of our patients received pharmacotherapy with either antidepressants or antipsychotics. 23.5 % (AN) and 21.1 % (BN) received no treatment with psychotherapy, antidepressants or antipsychotics.
This naturalistic study suggests that in young ED outpatients, EDs seem to be underdiagnosed and treatment does not necessarily comply with current guidelines. Therefore, dissemination of state-of-the-art knowledge on diagnosis and treatment in children and adolescents with EDs constitutes an important educational goal.
本研究旨在调查德国儿童和青少年饮食障碍（ED）患者的患病率、精神共病和门诊治疗情况。
对一家大型德国法定健康保险公司的数据进行了分析，并确定了 2009 年患有 ED 诊断的 10 至 21 岁门诊患者。
在 248558 名参保儿童和青少年中，有 1404 名患者（79.9%为女性，平均年龄：16.7；SD：3.3 岁）符合纳入标准。绝大多数神经性厌食症（AN）和神经性贪食症（BN）患者为女性（94.7%和 92.7%），以下分析将重点关注这两种疾病。女性的患病率分别为 0.28%（AN）和 0.20%（BN）。分别有 59.8%（AN）和 64.1%（BN）的患者被诊断为精神共病。大多数患者接受心理治疗（AN：75.7%，BN：78.5%），分别有 16.4%（AN）和 20.2%（BN）的患者接受抗抑郁药或抗精神病药的药物治疗。分别有 23.5%（AN）和 21.1%（BN）的患者未接受心理治疗、抗抑郁药或抗精神病药治疗。
本项自然主义研究表明，在年轻的 ED 门诊患者中，ED 似乎被漏诊，治疗不一定符合当前指南。因此，传播有关儿童和青少年 ED 的诊断和治疗的最新知识是一个重要的教育目标。
