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儿童和青少年的饮食失调:妇科医生需要了解什么?

Eating disorders in children and adolescents: what does the gynecologist need to know?

作者信息

Sieke Erin H, Rome Ellen S

机构信息

aCenter for Adolescent Medicine, Cleveland Clinic Lerner College of Medicine bCleveland Clinic Children's Hospital, Cleveland, Ohio, USA.

出版信息

Curr Opin Obstet Gynecol. 2016 Oct;28(5):381-92. doi: 10.1097/GCO.0000000000000317.

Abstract

PURPOSE OF REVIEW

The purpose of this review is to discuss the diagnosis, medical complications, and treatment of eating disorders as defined by the newly released Diagnostic and Statistical Manual, 5th edition.

RECENT FINDINGS

With the introduction of the Diagnostic and Statistical Manual, 5th edition, the diagnostic criteria for anorexia nervosa and bulimia nervosa have been revised to better capture the varied presentations of patients with eating disorders. In addition, new eating disorder diagnoses including binge-eating disorder, characterized by recurrent bingeing without associated compensatory behaviors, and avoidant/restrictive food intake disorder, characterized by a restrictive eating pattern without associated body dysmorphism, allow for increased recognition, diagnosis, and treatment of disordered eating patterns. In addition to a high mortality rate, eating disorders are associated with serious medical sequelae secondary to malnutrition and disordered behaviors, including disturbances of the cardiovascular, neurologic, gastrointestinal, reproductive, and skeletal systems. Early diagnosis and family-based treatment are associated with improved outcomes in children and adolescents.

SUMMARY

Eating disorders are illnesses with biological, psychological, and social implications that commonly present in childhood and adolescence. Gynecologists are on the front line for the screening and diagnosis of eating disorders in adolescent women.

摘要

综述目的

本综述旨在讨论根据最新发布的《精神疾病诊断与统计手册》第5版所定义的饮食失调症的诊断、医学并发症及治疗方法。

最新发现

随着《精神疾病诊断与统计手册》第5版的推出,神经性厌食症和神经性贪食症的诊断标准已得到修订,以便更好地涵盖饮食失调症患者的各种表现形式。此外,新的饮食失调症诊断类别包括暴饮暴食症(其特征为反复暴饮暴食且无相关代偿行为)和回避/限制性食物摄入障碍(其特征为饮食模式受限且无相关身体变形观念),这使得对饮食失调模式的识别、诊断及治疗有所增加。除了高死亡率外,饮食失调症还与营养不良及行为紊乱继发的严重医学后遗症相关,包括心血管、神经、胃肠、生殖及骨骼系统的紊乱。早期诊断及基于家庭的治疗与儿童和青少年更好的治疗结果相关。

总结

饮食失调症是具有生物学、心理学及社会影响的疾病,常见于儿童期和青少年期。妇科医生处于筛查和诊断青春期女性饮食失调症的前沿。

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