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初级保健中女性退伍军人的暴饮暴食:合并症与治疗重点

Binge Eating among Women Veterans in Primary Care: Comorbidities and Treatment Priorities.

作者信息

Rosenbaum Diane L, Kimerling Rachel, Pomernacki Alyssa, Goldstein Karen M, Yano Elizabeth M, Sadler Anne G, Carney Diane, Bastian Lori A, Bean-Mayberry Bevanne A, Frayne Susan M

机构信息

VA Palo Alto Health Care System, Health Services Research & Development, Center for Innovation to Implementation, Palo Alto, California; Department of Psychology, Drexel University, Philadelphia, Pennsylvania.

VA Palo Alto Health Care System, Health Services Research & Development, Center for Innovation to Implementation, Palo Alto, California; VA Palo Alto Health Care System, National Center for PTSD, Palo Alto, California.

出版信息

Womens Health Issues. 2016 Jul-Aug;26(4):420-8. doi: 10.1016/j.whi.2016.02.004. Epub 2016 Mar 10.

Abstract

BACKGROUND

Little is known about the clinical profile and treatment priorities of women with binge eating disorder (BED), a diagnosis new to the fifth edition of Diagnostic and Statistical Manual of Mental Disorders. We identified comorbidities and patients' treatment priorities, because these may inform implementation of clinical services.

METHODS

Data were collected from women veteran primary care patients. Analyses compared those who screened positive for BED (BED+), and those without any binge eating symptoms (BED-).

RESULTS

Frequencies of comorbid medical and psychological disorders were high in the BED+ group. The BED+ group's self-identified most common treatment priorities were mood concerns (72.2%), weight loss (66.7%), and body image/food issues (50%). Among those with obesity, a greater proportion of the BED+ group indicated body image/food issues was their top treatment priority (12.9% vs. 2.8%; p < .01), suggesting that these patients may be more apt to seek treatment beyond weight management for their problematic eating patterns.

CONCLUSIONS

Women primary care patients with BED demonstrate high medical and psychological complexity; their subjective treatment priorities often match objective needs. These findings may inform the development of targeted BED screening practices for women with obesity in primary care settings, and the eventual adoption of patient-centered BED treatment resources.

摘要

背景

对于暴饮暴食症(BED)女性患者的临床特征和治疗重点知之甚少,该病症是《精神疾病诊断与统计手册》第五版中的新增诊断。我们确定了共病情况和患者的治疗重点,因为这些可能为临床服务的实施提供参考。

方法

从女性退伍军人初级保健患者中收集数据。分析比较了筛查出暴饮暴食症呈阳性的患者(BED+)和没有任何暴饮暴食症状的患者(BED-)。

结果

BED+组中合并的医学和心理疾病发生率很高。BED+组自我认定的最常见治疗重点是情绪问题(72.2%)、体重减轻(66.7%)和身体形象/饮食问题(50%)。在肥胖患者中,BED+组中更大比例的患者表示身体形象/饮食问题是他们的首要治疗重点(12.9%对2.8%;p <.01),这表明这些患者可能更倾向于针对其有问题饮食模式寻求超出体重管理的治疗。

结论

患有BED的女性初级保健患者表现出较高的医学和心理复杂性;她们主观的治疗重点往往与客观需求相符。这些发现可能为在初级保健环境中为肥胖女性制定有针对性的BED筛查方法提供参考,并最终采用以患者为中心的BED治疗资源。

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