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低空腹催产素水平与神经性厌食症部分康复期的精神病理学有关。

Low Fasting Oxytocin Levels Are Associated With Psychopathology in Anorexia Nervosa in Partial Recovery.

作者信息

Afinogenova Yuliya, Schmelkin Cindy, Plessow Franziska, Thomas Jennifer J, Pulumo Reitumetse, Micali Nadia, Miller Karen K, Eddy Kamryn T, Lawson Elizabeth A

机构信息

Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

出版信息

J Clin Psychiatry. 2016 Nov;77(11):e1483-e1490. doi: 10.4088/JCP.15m10217.

Abstract

OBJECTIVE

Anorexia nervosa (AN), a psychiatric disorder characterized by restriction of food intake despite severe weight loss, is associated with increased comorbid anxiety and depression. Secretion of oxytocin, an appetite-regulating neurohormone with anxiolytic and antidepressant properties, is abnormal in AN. The link between oxytocin levels and psychopathology in AN has not been well explored.

METHODS

We performed a cross-sectional study of 79 women aged 18-45 years (19 AN, 26 AN in partial recovery [ANPR], and 34 healthy controls [HC]) investigating the relationship between basal oxytocin levels and disordered eating psychopathology, anxiety, and depressive symptoms. AN diagnoses were based on DSM-5 criteria. Data acquisition took place between December 2008 and March 2014. Fasting serum oxytocin levels were obtained, and the following self-report measures were used to assess psychopathology: Eating Disorder Examination Questionnaire, State-Trait Anxiety Inventory, and Beck Depression Inventory-II.

RESULTS

Fasting oxytocin levels were low in ANPR compared to HC (P = .0004). In ANPR but not AN, oxytocin was negatively associated with disordered eating psychopathology (r = -0.39, P = .0496) and anxiety symptoms (state anxiety: r = -0.53, P = .006; trait anxiety: r = -0.49, P = .01). Furthermore, ANPR with significant disordered eating psychopathology, anxiety symptoms, or depressive symptoms had lower oxytocin levels compared to those with minimal or no symptoms (P = .04, .02, and .007, respectively).

CONCLUSIONS

We speculate that a dysregulation of oxytocin pathways may contribute to persistent psychopathology after partial weight recovery from anorexia nervosa.

摘要

目的

神经性厌食症(AN)是一种精神疾病,其特征是尽管体重严重减轻仍限制食物摄入,常伴有焦虑和抑郁共病增加。催产素是一种具有抗焦虑和抗抑郁特性的食欲调节神经激素,其分泌在AN中异常。AN中催产素水平与精神病理学之间的联系尚未得到充分探索。

方法

我们对79名年龄在18 - 45岁的女性进行了一项横断面研究(19名AN患者、26名部分康复的AN患者[ANPR]和34名健康对照者[HC]),调查基础催产素水平与饮食失调精神病理学、焦虑和抑郁症状之间的关系。AN的诊断基于《精神疾病诊断与统计手册》第五版(DSM - 5)标准。数据采集于2008年12月至2014年3月期间进行。获取空腹血清催产素水平,并使用以下自我报告量表评估精神病理学:饮食失调检查问卷、状态 - 特质焦虑量表和贝克抑郁量表第二版。

结果

与HC相比,ANPR患者的空腹催产素水平较低(P = .0004)。在ANPR患者中而非AN患者中,催产素与饮食失调精神病理学(r = -0.39,P = .0496)和焦虑症状(状态焦虑:r = -0.53,P = .006;特质焦虑:r = -0.49,P = .01)呈负相关。此外,与症状轻微或无症状的ANPR患者相比,有明显饮食失调精神病理学、焦虑症状或抑郁症状的ANPR患者催产素水平较低(分别为P = .04、.02和.007)。

结论

我们推测,催产素通路失调可能导致神经性厌食症部分体重恢复后持续存在精神病理学问题。

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