Department of Child and Adolescent Psychiatry and Behavioral Health, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
Department of Pediatrics, Division of Child & Adolescent Psychiatry and Psychology, University of Louisville School of Medicine, Louisville, KY, United States; Norton Children's Hospital, Louisville, KY, United States; Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, TX, United States.
Handb Clin Neurol. 2020;175:387-403. doi: 10.1016/B978-0-444-64123-6.00026-6.
Eating disorders (EDs) are a group of prevalent psychiatric illnesses with an onset in early to late adolescence-a time of significant neural development, physical and psychologic growth, and self-exploration. The etiology and neurobiology of EDs are not well understood, but EDs are recognized as brain-based illnesses with serious acute and long-term consequences if undertreated or ignored. Two EDs, anorexia nervosa (AN) and bulimia nervosa (BN), have historically been the primary EDs of focus. The DSM-5 updated diagnostic criteria for these disorders added two more: binge-eating disorder (BED) and avoidant/restrictive food intake disorder (ARFID). EDs severely impact males as well as females across the weight spectrum. Comorbidity is high; mortality rates for AN and BN are the highest in psychiatric conditions and higher than many medical conditions. Several treatment options are available to treat an ED ranging from inpatient hospitalization to outpatient services and different psychotherapy options. This chapter reviews the diagnostic criteria, clinical presentation, and treatment for these disorders. Where available, sex differences and developmental considerations will be noted. For all EDs, early recognition and swift treatment are necessary to avoid a chronic course.
进食障碍(EDs)是一组常见的精神疾病,发病于青少年晚期至晚期——这是一个重要的神经发育、身体和心理成长以及自我探索的时期。EDs 的病因和神经生物学机制尚未得到很好的理解,但 EDs 被认为是基于大脑的疾病,如果治疗不当或忽视,会产生严重的急性和长期后果。两种 ED,神经性厌食症(AN)和神经性贪食症(BN),历来是主要关注的 ED。DSM-5 更新了这些疾病的诊断标准,增加了另外两种:暴食障碍(BED)和回避/限制型食物摄入障碍(ARFID)。ED 严重影响了体重范围内的男性和女性。共病率很高;AN 和 BN 的死亡率在精神疾病中最高,高于许多医学疾病。有几种治疗 ED 的选择,从住院治疗到门诊服务和不同的心理治疗选择。本章回顾了这些疾病的诊断标准、临床表现和治疗方法。在可能的情况下,将注意到性别差异和发展考虑因素。对于所有 ED,早期识别和迅速治疗是必要的,以避免慢性病程。