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日本样本中回避/限制型食物摄入障碍的临床表现及转归

Clinical presentation and outcome of avoidant/restrictive food intake disorder in a Japanese sample.

作者信息

Nakai Yoshikatsu, Nin Kazuko, Noma Shun'ichi, Hamagaki Seiji, Takagi Ryuro, Teramukai Satoshi, Wonderlich Stephen A

机构信息

Kyoto Institute of Health Sciences, Kyoto, Japan.

School of Health Sciences, Faculty of Medicine, Kyoto University, Kyoto, Japan.

出版信息

Eat Behav. 2017 Jan;24:49-53. doi: 10.1016/j.eatbeh.2016.12.004. Epub 2016 Dec 21.

Abstract

We conducted a study of the clinical presentation and outcome in patients with avoidant/restrictive food intake disorder (ARFID), aged 15-40years, and compared this group to an anorexia nervosa (AN) group in a Japanese sample. A retrospective chart review was completed on 245 patients with feeding and eating disorders (FEDs), analyzing prevalence, clinical presentation, psychopathological properties, and outcomes. Using the DSM-5 criteria, 27 (11.0%) out of the 245 patients with a FED met the criteria for ARFID at entry. All patients with ARFID were women. In terms of eating disorder symptoms, all patients with ARFID had restrictive eating related to emotional problems and/or gastrointestinal symptoms. However, none of the ARFID patients reported food avoidance related to sensory characteristics or functional dysphagia. Additionally, none of them exhibited binge eating or purging behaviors, and none of them reported excessive exercise. The ARFID group had a significantly shorter duration of illness, lower rates of admission history, and less severe psychopathology than the AN group. The ARFID group reported significantly better outcome results than the AN group. These results suggest that patients with ARFID in this study were clinically distinct from those with AN and somewhat different from pediatric patients with ARFID in previous studies.

摘要

我们对年龄在15至40岁之间的回避/限制性食物摄入障碍(ARFID)患者的临床表现及预后进行了一项研究,并将该组与日本样本中的神经性厌食症(AN)组进行了比较。对245例进食障碍(FED)患者进行了回顾性病历审查,分析了患病率、临床表现、精神病理学特征及预后。根据《精神疾病诊断与统计手册》第五版(DSM-5)标准,245例FED患者中有27例(11.0%)在入组时符合ARFID标准。所有ARFID患者均为女性。在进食障碍症状方面,所有ARFID患者都存在与情绪问题和/或胃肠道症状相关的限制性饮食。然而,没有一名ARFID患者报告与感官特征或功能性吞咽困难相关的食物回避。此外,他们中没有人表现出暴饮暴食或清除行为,也没有人报告过度运动。与AN组相比,ARFID组的病程明显更短,入院史发生率更低,精神病理学症状也较轻。ARFID组报告的预后结果明显优于AN组。这些结果表明,本研究中的ARFID患者在临床上与AN患者不同,且与既往研究中的儿科ARFID患者有所差异。

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