Dapelo Marcela M, Gil Aurora A, Lacalle Lucas, Vogel Melina
Center for Studies in Eating Behavior, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile.
Eating Disorders Unit, Psychiatry Department, Faculty of Medicine, Pontificia Universidad Católica, Santiago, Chile.
Front Psychiatry. 2020 Aug 28;11:869. doi: 10.3389/fpsyt.2020.00869. eCollection 2020.
One in five patients with eating disorders (EDs) may take a lasting course. It has been proposed that this enduring group exhibits increased severity, such as low treatment response, severe symptomatology, and poor quality of life. However, there is no consensus defining this group. Moreover, most of the literature comes from high-income societies and may not apply to developing countries.
This study aimed to evaluate the association between endurance (length of ED) and severity (previous treatments, hospitalizations, medical complications, symptomatology and clinical impairment) in individuals with EDs from Chile. In addition, it aimed to explore the association between endurance and delays seeking specialized treatment.
Forty-one women with EDs (16 with anorexia nervosa, 11 with bulimia nervosa, 10 with binge eating disorder and 4 with other specified EDs) completed a social-demographic survey, the Eating Disorders Examination Questionnaire, and the Clinical Impairment Assessment. Also, Body Mass Index, length of ED, and complications were retrieved from participants' medical records. Spearman correlation coefficient and linear regression were used to explore the association between length of ED and measures of severity and treatment seeking behavior.
There was no significant association between endurance (length of ED) and measures of severity. There was a significant association between length of ED and delays seeking specialized treatment (r=0.72; p<0.01). Regression indicated that for each month in delay visiting a specialized ED treatment team, the ED duration increased by 0.87 months (F(1,38)=75.93; p<0.01; R= 0.66).
The findings suggest that in developing countries, where specialized treatment access is not widespread, defining SEED solely by the length of illness may not be clinically significant, and other criteria (e.g., timely access to evidence-based treatments) should be considered.
五分之一的饮食失调患者病程可能持久。有人提出，这一病程持久的群体病情更为严重，例如治疗反应差、症状严重以及生活质量低下。然而，对于如何界定这一群体尚无共识。此外，大多数文献来自高收入社会，可能并不适用于发展中国家。
本研究旨在评估智利饮食失调患者的病程持久性（饮食失调时长）与病情严重程度（既往治疗、住院、医疗并发症、症状及临床损害）之间的关联。此外，还旨在探究病程持久性与寻求专科治疗延迟之间的关联。
41名饮食失调女性（16名神经性厌食症患者、11名神经性贪食症患者、10名暴饮暴食症患者以及4名其他特定饮食失调患者）完成了一项社会人口学调查、饮食失调检查问卷以及临床损害评估。此外，还从参与者的病历中获取了体重指数、饮食失调时长及并发症情况。采用斯皮尔曼相关系数和线性回归来探究饮食失调时长与病情严重程度及寻求治疗行为指标之间的关联。
病程持久性（饮食失调时长）与病情严重程度指标之间无显著关联。饮食失调时长与寻求专科治疗延迟之间存在显著关联（r = 0.72；p < 0.01）。回归分析表明，每延迟一个月就诊于专科饮食失调治疗团队，饮食失调持续时间就会增加0.87个月（F(1,38)=75.93；p < 0.01；R = 0.66）。
研究结果表明，在专科治疗普及程度不高的发展中国家，仅依据病程长短来界定病程持久的饮食失调可能并无临床意义，还应考虑其他标准（例如及时获得循证治疗）。
