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神经性厌食症与功能性运动症状:同一枚硬币的两面?

Anorexia Nervosa and Functional Motor Symptoms: Two Faces of the Same Coin?

作者信息

Demartini Benedetta, Goeta Diana, Romito Luigi, Anselmetti Simona, Bertelli Sara, D'Agostino Armando, Gambini Orsola

机构信息

From the Cattedra di Psichiatria-Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy (BD, DG, SA, SB, AD, OG); and UOC Neurologia I - Movement Disorders, IRCCS Fondazione Istituto Neurologico Carlo Besta, Milano, Italy (LR).

出版信息

J Neuropsychiatry Clin Neurosci. 2017 Fall;29(4):383-390. doi: 10.1176/appi.neuropsych.16080156. Epub 2017 May 31.

Abstract

The aim of this study was to compare anorexia nervosa (AN) patients and functional motor symptoms (FMS) patients by assessing their variability in demographic and clinical characteristics, risk factors, precipitators, and family history. The authors assessed levels of depression and anxiety, alexithymia, dissociation, body awareness, self-objectification, and interoception in the two groups, using 20 healthy controls (HCs) as a control group for psychometric assessment and for interoception. Unexpectedly, no differences in the three groups were observed for the measures related to awareness of physical state, including body awareness, self-objectification, and interoceptive ability via the heartbeat task. However, the AN and FMS groups were not different from each other but were different from the HC group with regard to anxiety, depression, alexithymia, and dissociation. In light of the similarities found, these data support the hypothesis of a common etiology involving emotional dysfunction in both disorders. These findings suggest that AN and FMS may be disorders belonging to the same spectrum (where emotional dysregulation is a key feature) and that there exist potential opportunities for collaborative, integrated investigations of etiology, diagnosis, and management of these disorders.

摘要

本研究的目的是通过评估神经性厌食症(AN)患者和功能性运动症状(FMS)患者在人口统计学和临床特征、危险因素、诱发因素及家族史方面的变异性,对二者进行比较。作者评估了两组患者的抑郁和焦虑水平、述情障碍、分离、身体意识、自我客体化及内感受,将20名健康对照者(HCs)作为心理测量评估和内感受的对照组。出乎意料的是,在与身体状态意识相关的测量中,包括身体意识、自我客体化以及通过心跳任务测得的内感受能力,三组之间未观察到差异。然而,在焦虑、抑郁、述情障碍和分离方面,AN组和FMS组彼此无差异,但与HC组不同。鉴于所发现的相似性,这些数据支持了两种疾病存在涉及情绪功能障碍的共同病因这一假说。这些发现表明,AN和FMS可能属于同一谱系的疾病(其中情绪失调是关键特征),并且在这些疾病的病因、诊断和管理方面存在合作性综合研究的潜在机会。

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