Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Schön Klinik Roseneck, Prien am Chiemsee, Germany.
Brain Behav. 2020 Mar;10(3):e01556. doi: 10.1002/brb3.1556. Epub 2020 Feb 4.
Continued mobility in the presence of severe weight loss is a well known, yet insufficiently researched characteristic of anorexia nervosa (AN). This study was designed to assess the prevalence of the drive for activity, here operationalized as an increased urge for movement, physical restlessness, and mental restlessness.
Participants were 83 female consecutively admitted adolescent patients qualifying for a diagnosis of AN (ICD-10), restricting subtype. Information collected included responses to a questionnaire inquiring retrospectively about physical and psychological reactions after significant weight loss (on average 12.5 kg) and to measures of psychiatric and eating disorder pathology and exercise behaviors at hospital admission.
Over 80% of AN patients reported experiencing, at least partly, either, an increased urge for movement, physical or mental restlessness after significant weight loss. Altogether 95.1% reported, at least partly, one or a combination of two or all three symptoms. The sensations coexisted with equally high levels of fatigue and loss of energy, typically observed in starvation. The increased urge for movement and physical restlessness were foremost associated with reported actual physical activity and with weight loss. By contrast, mental restlessness was strongly linked to the degree of eating disorder pathology and to the severity of psychiatric symptoms.
This is the first investigation of the presence of an increased urge for movement, physical restlessness, and mental restlessness after significant weight loss in patients with acute AN. The symptoms, given their high frequency and specificity, are likely pathogenic for AN and, if replicated, deserve to be considered for inclusion as diagnostic criteria for AN.
在严重体重减轻的情况下保持持续的活动能力是神经性厌食症（AN）的一个众所周知但研究不足的特征。本研究旨在评估活动动力的患病率，即增加的运动冲动、身体不安和精神不安。
参与者为 83 名连续入院的符合 AN（ICD-10，限制型）诊断标准的女性青少年患者。收集的信息包括对问卷的回答，该问卷回顾性地询问了在显著体重减轻（平均 12.5 公斤）后身体和心理反应，以及入院时的精神和饮食障碍病理以及运动行为的测量。
超过 80%的 AN 患者报告在显著体重减轻后至少部分经历了运动冲动增加、身体或精神不安。共有 95.1%的患者报告至少部分出现了一种或两种或三种症状的组合。这些感觉与同样高的疲劳和能量丧失共存，这在饥饿中很常见。运动冲动增加和身体不安主要与报告的实际身体活动和体重减轻有关。相比之下，精神不安与饮食障碍的严重程度和精神症状的严重程度密切相关。
这是首次对急性 AN 患者在显著体重减轻后出现运动冲动增加、身体不安和精神不安的研究。这些症状由于其高频率和特异性，可能是 AN 的致病因素，如果得到复制，值得考虑纳入 AN 的诊断标准。
