Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
Timothy D. Brewerton, MD, LLC, Mt. Pleasant, South Carolina, USA.
Int J Eat Disord. 2020 Dec;53(12):2061-2066. doi: 10.1002/eat.23401. Epub 2020 Nov 6.
Traumatic events, posttraumatic stress disorder (PTSD) and related symptoms are commonly associated with eating disorders (ED). Several clinical features indicative of a more severe and complex course have been associated with traumatized ED patients, especially those with PTSD, who may be more likely admitted to residential treatment (RT). Research in this population is sparse but of increasing interest.
Adult participants (96.7% female) with EDs entering RT (n = 642) at seven sites in the U.S. completed validated self-report assessments of ED, PTSD, major depression, state-trait anxiety, and quality of life. Presumptive diagnoses of DSM-5 PTSD (PTSD+) were made via the Life Events Checklist-5 and the PTSD Symptom Checklist for DSM-5.
PTSD+ occurred in 49.3% of patients. PTSD+ patients had significantly higher scores on all assessment measures (p ≤ .001), including measures of ED psychopathology, depression, state-trait anxiety, and quality of life. Those with PTSD+ had significantly higher numbers of lifetime traumatic event types, higher rates of almost all lifetime traumatic events, and a greater propensity toward binge-type EDs.
Results confirm that ED-PTSD+ patients in RT are more symptomatic and have worse quality of life than ED patients without PTSD+. Integrated treatment approaches that effectively address ED-PTSD+ are greatly needed.
创伤事件、创伤后应激障碍（PTSD）和相关症状通常与饮食失调（ED）有关。一些表明更严重和复杂病程的临床特征与创伤后 ED 患者有关，尤其是那些患有 PTSD 的患者，他们更有可能接受住院治疗（RT）。该人群的研究较少，但越来越受到关注。
在美国七个地点接受 RT 的 ED 成年参与者（96.7%为女性，n=642）完成了 ED、PTSD、重度抑郁症、状态-特质焦虑和生活质量的经过验证的自我报告评估。通过生活事件清单-5 和 PTSD 症状清单-5 对 DSM-5 PTSD（PTSD+）进行了推定诊断。
49.3%的患者患有 PTSD+。PTSD+患者在所有评估指标上的得分都显著更高（p≤0.001），包括 ED 病理、抑郁、状态-特质焦虑和生活质量的评估指标。那些患有 PTSD+的患者一生中经历过的创伤性事件类型更多，一生中几乎所有创伤性事件的发生率更高，且更易发生暴食型 ED。
结果证实，接受 RT 的 ED-PTSD+患者比没有 PTSD+的 ED 患者症状更严重，生活质量更差。非常需要采用综合治疗方法来有效治疗 ED-PTSD+。
