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青少年期起病的神经性厌食症的长期结局与精神共病

Long-term outcome and psychiatric comorbidity of adolescent-onset anorexia nervosa.

作者信息

Andrés-Pepiñá Susana, Plana Maria Teresa, Flamarique Itziar, Romero Sonia, Borràs Roger, Julià Laia, Gárriz Miguel, Castro-Fornieles Josefina

机构信息

Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Spain.

Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain.

出版信息

Clin Child Psychol Psychiatry. 2020 Jan;25(1):33-44. doi: 10.1177/1359104519827629. Epub 2019 Feb 15.

Abstract

OBJECTIVE

To assess the outcome of adolescents with anorexia nervosa (AN) about 20 years after first treatment.

METHODS

Sixty-two women diagnosed with AN during adolescence were invited to participate. Of these 62 patients, 38 agreed to participate and were assessed with a battery of questionnaires and interviews. A control group of 30 women of similar age was also assessed.

RESULTS

Of the patients who completed the full assessment, 13 (34%) presented some degree of eating disorder (ED) at follow-up (10 (26%) met full (5th ed.; DSM-5) criteria for an ED and 3 (8%) showed partial remission of an ED). The remaining 25 (66%) patients had fully recovered from AN. The duration of untreated illness before admission was significantly associated with an increased risk of a current ED (odds ratio (OR) = 3.334 (1.3-8.7);  = .014). Of the patients who had recovered totally from their ED, 24% showed another psychiatric disorder. This percentage rose to 70% in patients with a current ED.

CONCLUSION

Sixty-six percent of adolescents who completed the assessment achieved remission of their AN. Comorbidity was more common in the current ED group. The variable that best predicted complete remission was the number of years without treatment, showing the importance of detection and early intervention.

摘要

目的

评估神经性厌食症(AN)青少年患者首次治疗约20年后的预后情况。

方法

邀请62名在青少年期被诊断为AN的女性参与研究。在这62名患者中,38名同意参与,并接受了一系列问卷调查和访谈评估。还对30名年龄相仿的女性组成的对照组进行了评估。

结果

在完成全面评估的患者中,13名(34%)在随访时出现了某种程度的饮食失调(ED)(10名(26%)符合ED的完全(第5版;《精神疾病诊断与统计手册》第5版)标准,3名(8%)显示ED部分缓解)。其余25名(66%)患者已从AN中完全康复。入院前未治疗疾病的持续时间与当前发生ED的风险增加显著相关(优势比(OR)=3.334(1.3 - 8.7);P = 0.014)。在已从ED中完全康复的患者中,24%出现了另一种精神障碍。在当前患有ED的患者中,这一比例升至70%。

结论

完成评估的青少年中,66%的AN患者实现了缓解。合并症在当前的ED组中更为常见。最能预测完全缓解的变量是未治疗的年数,这表明了检测和早期干预的重要性。

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