DSM-5 定义的饮食障碍在全美代表性成年人样本中的流行率及相关因素。
Prevalence and Correlates of DSM-5-Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults.
机构信息
Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, State University of New York, Albany, New York.
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
出版信息
Biol Psychiatry. 2018 Sep 1;84(5):345-354. doi: 10.1016/j.biopsych.2018.03.014. Epub 2018 Apr 17.
BACKGROUND
Few population-based data on the prevalence of eating disorders exist, and such data are especially needed because of changes to diagnoses in the DSM-5. This study aimed to provide lifetime and 12-month prevalence estimates of DSM-5-defined anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions.
METHODS
A national sample of 36,306 U.S. adults completed structured diagnostic interviews (Alcohol Use Disorder and Associated Disabilities Interview Schedule-5).
RESULTS
Prevalence estimates of lifetime AN, BN, and BED were 0.80% (SE 0.07%), 0.28% (SE 0.03%), and 0.85% (SE 0.05%), respectively. Twelve-month estimates for AN, BN, and BED were 0.05% (SE 0.02%), 0.14% (SE 0.02%), and 0.44% (SE 0.04%). The odds of lifetime and 12-month diagnoses of all three eating disorders were significantly greater for women than for men after adjusting for age, race and/or ethnicity, education, and income. Adjusted odds ratios (AORs) of lifetime AN diagnosis were significantly lower for non-Hispanic black and Hispanic respondents than for white respondents. AORs of lifetime and 12-month BN diagnoses did not differ significantly by race and/or ethnicity. The AOR of lifetime, but not 12-month, BED diagnosis was significantly lower for non-Hispanic black respondents relative to that of non-Hispanic white respondents; AORs of BED for Hispanic and non-Hispanic white respondents did not differ significantly. AN, BN, and BED were characterized by significant differences in age of onset, persistence and duration of episodes, and rates of current obesity and psychosocial impairment.
CONCLUSIONS
These findings for DSM-5-defined eating disorders, based on the largest national sample of U.S. adults studied to date, indicate some important similarities to and differences from earlier, smaller nationally representative studies.
背景
关于饮食障碍的患病率，目前仅有少量基于人群的研究数据，而 DSM-5 对这些疾病的诊断标准进行了修订，因此我们特别需要这些数据。本研究旨在利用 2012-2013 年全国酒精相关情况和障碍调查（Alcohol Use Disorder and Associated Disabilities Interview Schedule-5）的数据，提供 DSM-5 定义的神经性厌食症（AN）、神经性贪食症（BN）和暴食障碍（BED）的终生和 12 个月患病率估计值。
方法
本研究采用全国性样本，共纳入 36306 名美国成年人，他们完成了结构化诊断访谈（Alcohol Use Disorder and Associated Disabilities Interview Schedule-5）。
结果
终生 AN、BN 和 BED 的患病率估计值分别为 0.80%（SE 0.07%）、0.28%（SE 0.03%）和 0.85%（SE 0.05%）。12 个月的估计值分别为 0.05%（SE 0.02%）、0.14%（SE 0.02%）和 0.44%（SE 0.04%）。调整年龄、种族和/或民族、教育程度和收入后，女性终生和 12 个月的三种饮食障碍诊断的可能性均显著高于男性。调整后的比值比（AOR）显示，与白人相比，非西班牙裔黑人或西班牙裔受访者终生 AN 诊断的可能性显著更低。种族和/或民族对 BN 终生和 12 个月的诊断没有显著影响。与非西班牙裔白人相比，非西班牙裔黑人受访者终生 BED 诊断的 AOR 显著降低，但 12 个月 BED 诊断的 AOR 没有显著差异。非西班牙裔黑人受访者 BED 诊断的 AOR 显著低于非西班牙裔白人受访者，而西班牙裔和非西班牙裔白人受访者的 BED 诊断的 AOR 则没有显著差异。AN、BN 和 BED 在发病年龄、发作的持续时间和发作的持续时间、当前肥胖和心理社会障碍的发生率等方面存在显著差异。
结论
这些基于迄今研究过的最大的美国成年人全国性样本的 DSM-5 定义的饮食障碍数据表明，与早期的、较小的全国代表性研究相比，这些数据既有一些重要的相似之处，也有一些不同之处。
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