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[双相情感障碍与神经性厌食症:一项临床研究]

[Bipolar disorders and anorexia nervosa: A clinical study].

作者信息

Valentin M, Radon L, Duclos J, Curt F, Godart N

机构信息

Centre hospitalier d'Argenteuil, 69, rue du Lieutenant-Colonel-Prudhon, 95100 Argenteuil, France.

Département de psychiatrie, institut Mutualiste-Montsouris (IMM), 42, boulevard Jourdan, 75014 Paris, France; UVSQ, CESP, Inserm, université Paris-Saclay, université Paris-Sud, 92800 Villejuif, France; Nightingale Hospitals Paris, clinique du Château-de-Garches, 11 bis, rue de la Porte-Jaune, 92380 Garches, France.

出版信息

Encephale. 2019 Feb;45(1):27-33. doi: 10.1016/j.encep.2017.10.005. Epub 2018 Jun 21.

Abstract

PURPOSE

Anorexia nervosa is often accompanied by comorbid mood disorders, in particular depression, but individual or family history of bipolar disorders has not frequently been explored in anorexia nervosa. The objectives of the present study were: (1) to assess the frequency of bipolar disorders in patients with anorexia nervosa hospitalized in adolescence and in their parents, (2) to determine whether the patients with a personal or family history of bipolar disorders present particular characteristics in the way in which anorexia nervosa manifests itself, in their medical history, in the secondary diagnoses established, and in the treatments prescribed.

METHOD

Overall, 97 female patients aged 13 to 20 hospitalized for anorexia nervosa and their parents were assessed. The diagnoses of anorexia nervosa and bipolar disorders were established on the basis of DSM-IV-TR criteria.

RESULTS

A high frequency of type II and type V bipolar disorders was observed. The patients with anorexia nervosa and presenting personal or family histories of bipolar disorder had an earlier onset of anorexia nervosa, more numerous hospitalizations, a longer time-lapse between anorexia nervosa onset and hospitalization, more suicide attempts and more psychiatric comorbidities.

CONCLUSION

The occurrence of anorexia nervosa-bipolar disorders comorbidity appears to be considerable and linked to the severity of anorexia nervosa, raising the issue of the relationship between anorexia nervosa and bipolar disorders.

摘要

目的

神经性厌食症常伴有共病性情绪障碍,尤其是抑郁症,但神经性厌食症患者的个人或家族双相情感障碍病史尚未得到充分探究。本研究的目的是:(1)评估青少年期住院的神经性厌食症患者及其父母中双相情感障碍的发生率;(2)确定有双相情感障碍个人或家族病史的患者在神经性厌食症的表现方式、病史、确诊的继发性诊断以及所采用的治疗方法上是否具有特殊特征。

方法

总共评估了97名因神经性厌食症住院的13至20岁女性患者及其父母。神经性厌食症和双相情感障碍的诊断基于《精神疾病诊断与统计手册》第四版修订版(DSM-IV-TR)标准。

结果

观察到II型和V型双相情感障碍的高发生率。有神经性厌食症且有双相情感障碍个人或家族病史的患者神经性厌食症起病更早、住院次数更多、神经性厌食症起病与住院之间的时间间隔更长、自杀未遂次数更多且精神科共病更多。

结论

神经性厌食症与双相情感障碍共病的发生率似乎相当高,且与神经性厌食症的严重程度相关,这引发了神经性厌食症与双相情感障碍之间关系的问题。

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