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神经性厌食症遗传学倡议:澳大利亚和新西兰分部的研究描述及样本特征

The Anorexia Nervosa Genetics Initiative: Study description and sample characteristics of the Australian and New Zealand arm.

作者信息

Kirk Katherine M, Martin Felicity C, Mao Amy, Parker Richard, Maguire Sarah, Thornton Laura M, Zhu Gu, McAloney Kerrie, Freeman Jeremy L, Hay Phillipa, Madden Sloane, Morgan Christine, Russell Janice, Sawyer Susan M, Hughes Elizabeth K, Fairweather-Schmidt A Kate, Fursland Anthea, McCormack Julie, Wagg Fiona, Jordan Jennifer, Kennedy Martin A, Ward Warren, Wade Tracey D, Bulik Cynthia M, Martin Nicholas G

机构信息

1 Genetic Epidemiology Laboratory, QIMR Berghofer Institute of Medical Research, Brisbane, QLD, Australia.

2 Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.

出版信息

Aust N Z J Psychiatry. 2017 Jun;51(6):583-594. doi: 10.1177/0004867417700731. Epub 2017 Apr 5.

Abstract

OBJECTIVES

Anorexia nervosa is a severe psychiatric disorder with high mortality rates. While its aetiology is poorly understood, there is evidence of a significant genetic component. The Anorexia Nervosa Genetics Initiative is an international collaboration which aims to understand the genetic basis of the disorder. This paper describes the recruitment and characteristics of the Australasian Anorexia Nervosa Genetics Initiative sample, the largest sample of individuals with anorexia nervosa ever assembled across Australia and New Zealand.

METHODS

Participants completed an online questionnaire based on the Structured Clinical Interview Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) eating disorders section. Participants who met specified case criteria for lifetime anorexia nervosa were requested to provide a DNA sample for genetic analysis.

RESULTS

Overall, the study recruited 3414 Australians and 543 New Zealanders meeting the lifetime anorexia nervosa case criteria by using a variety of conventional and social media recruitment methods. At the time of questionnaire completion, 28% had a body mass index ⩽ 18.5 kg/m. Fasting and exercise were the most commonly employed methods of weight control, and were associated with the youngest reported ages of onset. At the time of the study, 32% of participants meeting lifetime anorexia nervosa case criteria were under the care of a medical practitioner; those with current body mass index < 18.5 kg/m were more likely to be currently receiving medical care (56%) than those with current body mass index ⩾ 18.5 kg/m (23%). Professional treatment for eating disorders was most likely to have been received from general practitioners (45% of study participants), dietitians (42%) and outpatient programmes (42%).

CONCLUSIONS

This study was effective in assembling the largest community sample of people with lifetime anorexia nervosa in Australia and New Zealand to date. The proportion of people with anorexia nervosa currently receiving medical care, and the most common sources of treatment accessed, indicates the importance of training for general practitioners and dietitians in treating anorexia nervosa.

摘要

目的

神经性厌食症是一种死亡率很高的严重精神疾病。虽然其病因尚不清楚,但有证据表明存在显著的遗传因素。神经性厌食症遗传学倡议是一项国际合作项目,旨在了解该疾病的遗传基础。本文描述了澳大拉西亚神经性厌食症遗传学倡议样本的招募情况和特征,该样本是澳大利亚和新西兰有史以来汇集的最大的神经性厌食症患者样本。

方法

参与者完成了一份基于《精神疾病诊断与统计手册》(第4版;DSM-IV)饮食失调部分的在线问卷。符合终身神经性厌食症特定病例标准的参与者被要求提供DNA样本进行基因分析。

结果

总体而言,该研究通过多种传统和社交媒体招募方法,招募了3414名澳大利亚人和543名新西兰人,他们符合终身神经性厌食症病例标准。在完成问卷时,28%的人体重指数≤18.5kg/m²。禁食和运动是最常用的体重控制方法,且与报告的最早发病年龄相关。在研究时,符合终身神经性厌食症病例标准的参与者中,32%正在接受医生治疗;当前体重指数<18.5kg/m²的参与者比当前体重指数≥18.5kg/m²的参与者更有可能正在接受医疗护理(56%对23%)。饮食失调的专业治疗最有可能来自全科医生(45%的研究参与者)、营养师(42%)和门诊项目(42%)。

结论

本研究成功汇集了澳大利亚和新西兰迄今为止最大的终身神经性厌食症患者社区样本。目前接受医疗护理的神经性厌食症患者比例以及最常见的治疗来源,表明了对全科医生和营养师进行神经性厌食症治疗培训的重要性。

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