Vinai Piergiuseppe, Da Ros Annalisa, Speciale Maurizio, Gentile Nicola, Tagliabue Anna, Vinai Paolo, Bruno Cecilia, Vinai Luisa, Studt Stacia, Cardetti Silvia
"Studi Cognitivi" Post-graduate Cognitive Psychotherapy School Milano, Italy; GNOSIS non-profit research group, Cuneo, Italy.
"Studi Cognitivi" Post-graduate Cognitive Psychotherapy School Milano, Italy; GNOSIS non-profit research group, Cuneo, Italy; Eating Disorders and Obesity Surgery, ULSS 13, Mirano-Dolo, Venice, Italy.
Eat Behav. 2015 Jan;16:1-4. doi: 10.1016/j.eatbeh.2014.10.004. Epub 2014 Nov 1.
We evaluate whether there are any significant differences in psychopathology between severe obese patients affected by Binge Eating Disorder diagnosed following both the DSM IV TR and the DSM5 criteria, and severe obese patients not having an eating disorder.
118 severe obese patients seeking treatment at a center for bariatric surgery in northern Italy were asked to take part in the current study for a period of six months. Average participant age was 44.27 years, SD 12.42. Age ranged from 18 to 67 years. Average patient BMI was 45.03, SD 7.11, ranging from 32.14 to 66.16 kg/m(2). Seventy seven of the patients (65.3%) were females and 41 (34.7%) were males. BED diagnosis was determined following the diagnostic criteria of both the DSM IV TR and the DSM 5. The presence of other eating disorders was excluded through a clinical screening using the Eating Disorder Inventory (EDI). Patient eating habits and the presence of emotional eating were appraised using the Three-Factor Eating Questionnaire. Levels of depression and anxiety were evaluated using the Beck Depression Inventory and the State Trait Anxiety Inventory.
57 out of 118 patients were found to be affected by BED following the DSM 5 criteria; among them 24 followed those of the DSM IV TR. BED patients scored higher on four subscales of the Eating Disorders Inventory: Drive for thinness (DT), Bulimia (B), Body dissatisfaction (BD) and Interoceptive awareness (IA) on the STAI and on the Disinhibition and Hunger subscales of the TFEQ.
The results confirm the presence of high levels of psychopathology among patients diagnosed with BED, even if they have been diagnosed following the criteria of the DSM 5. There is a great overlap in psychopathology between BED patients diagnosed following the DSM IV TR and the DSM 5 criteria.
我们评估了按照《精神疾病诊断与统计手册》第四版修订版(DSM IV TR)和第五版(DSM5)标准诊断为暴饮暴食症的重度肥胖患者与未患饮食失调症的重度肥胖患者在精神病理学方面是否存在显著差异。
在意大利北部一家减肥手术中心寻求治疗的118名重度肥胖患者被要求参与本研究,为期六个月。参与者平均年龄为44.27岁,标准差为12.42。年龄范围为18至67岁。患者平均体重指数(BMI)为45.03,标准差为7.11,范围为32.14至66.16kg/m²。其中77名患者(65.3%)为女性,41名(34.7%)为男性。根据DSM IV TR和DSM 5的诊断标准确定暴饮暴食症的诊断。通过使用饮食失调问卷(EDI)进行临床筛查排除其他饮食失调症的存在。使用三因素饮食问卷评估患者的饮食习惯和情绪化饮食的存在情况。使用贝克抑郁量表和状态特质焦虑量表评估抑郁和焦虑水平。
按照DSM 5标准,118名患者中有57名被发现患有暴饮暴食症;其中24名符合DSM IV TR的标准。暴饮暴食症患者在饮食失调问卷的四个子量表上得分更高:追求瘦身(DT)、暴食(B)、身体不满(BD)以及在状态特质焦虑量表上的内感受性意识(IA),以及在三因素饮食问卷的去抑制和饥饿子量表上得分更高。
结果证实,即使按照DSM 5标准诊断,被诊断为暴饮暴食症的患者中也存在高水平的精神病理学。按照DSM IV TR和DSM 5标准诊断的暴饮暴食症患者在精神病理学方面存在很大重叠。