Schoen Clinic Roseneck, Prien, Germany; Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Germany.
Schoen Clinic Roseneck, Prien, Germany.
J Affect Disord. 2019 Oct 1;257:758-764. doi: 10.1016/j.jad.2019.06.029. Epub 2019 Jun 29.
While it is know that depressive symptoms are common in eating disorders (EDs), it is unclear whether these symptoms differ from those in depressive disorders (DDs) with regard to severity and quality.
Beck Depression Inventory II (BDI-II) scores at admission to treatment of 4.895 inpatients with a unipolar DD and 3.302 inpatients with an ED were compared by means of independent t-tests and Cohen's d effect sizes with regard to: (1) overall severity (BDI-II total score), (2) six facets of depression identified by non-metric multidimensional scaling of the German BDI-II validation sample, and (3) individual items.
(1) The two groups did not differ with regard to the BDI-II total score. (2) There was no difference in the facet Depressive Core Symptoms. Patients with DDs had higher scores for Diminished Activation (d = 0.40) and patients with EDs had higher scores for Negative View of Self (d = 0.40). (3) Patients with DDs showed higher score on the item Loss of Energy (d = 0.48), while patients with EDs sored higher on Self-Dislike (d = 0.48) and Changes of Appetite (d = 0.48).
Depression in EDs seems to be as severe as in DDs and may show similar core aspects (e.g., Sadness, Loss of Pleasure). Qualitative differences suggested that individual additional symptoms of depression need to be differently addressed in therapy. The pronounced Negative View of Self in EDs is in line with the "core low self-esteem", a central component of the prevalent transdiagnostic model of EDs.
虽然抑郁症状在饮食障碍（ED）中很常见，但尚不清楚这些症状在严重程度和质量方面是否与抑郁障碍（DD）不同。
通过独立 t 检验和 Cohen's d 效应大小，比较了 4.895 名单相 DD 住院患者和 3.302 名 ED 住院患者入院时贝克抑郁量表 II（BDI-II）评分，比较的方面包括：（1）整体严重程度（BDI-II 总分），（2）德国 BDI-II 验证样本非度量多维标度确定的六个抑郁方面，和（3）个体项目。
（1）两组在 BDI-II 总分方面没有差异。（2）抑郁核心症状方面没有差异。DD 患者在激活减少方面的得分较高（d=0.40），ED 患者在自我消极看法方面的得分较高（d=0.40）。（3）DD 患者在乏力项目上的得分较高（d=0.48），而 ED 患者在自我厌恶（d=0.48）和食欲变化（d=0.48）方面的得分较高。
ED 中的抑郁似乎与 DD 一样严重，并且可能表现出相似的核心方面（例如，悲伤、快感丧失）。定性差异表明，在治疗中需要对抑郁的个别附加症状进行不同的处理。ED 中明显的自我消极看法与“核心低自尊”一致，这是 ED 普遍的跨诊断模型的核心组成部分。
