Eating Disorders Center, Department of Neuroscience, University of Turin, 10126 Turin, Italy.
Medicina (Kaunas). 2020 Dec 22;57(1):2. doi: 10.3390/medicina57010002.
: Anorexia nervosa (AN) is a complex disorder whose etiopathogenesis involves both biological and environmental factors. The aims of the present study were to retrospectively analyze risk factors in young patients with AN and to assess differences in clinical and eating-related symptoms between patients with and without a diagnosis of post-traumatic stress disorder (PTSD) and with or without a history of acknowledged risk factors. : Sixty-four patients with AN (<25 years old) were recruited and completed an anamnestic evaluation and the following self-report measures: Eating Disorder Examination Questionnaire (EDE-Q), Childhood Trauma Questionnaire (CTQ), State-Trait Anxiety Inventory (STAI-Y), Beck Depression Inventory (BDI), Life Events Checklist (LEC), and Dissociative Experience Scale (DES). The PTSD diagnosis was assigned according to the Structured Clinical Interview for the DSM-5 (SCID-5). : The most frequent risk factors were those associated with relational traumatic events and familiarity for psychiatric disorders. Higher severity of body-related symptoms (i.e., those symptoms impacting on body image and perception and leading to body concerns) emerged in patients with PTSD, versus patients without PTSD diagnosis; however, after controlling for dissociative symptoms, only differences in BMI remained significant. Concerning other risk factors, those with a history of childhood trauma were more depressed than patients without such history and those with familiarity with eating disorders reported more AN-related hospitalizations in the past than those individuals without familiarity. : These results suggest the importance of investigating the presence of risk factors and PTSD diagnosis in patients with AN, and to treat post-traumatic symptoms in young patients in order to decrease the risk of developing severe forms of AN. Moreover, a particular focus on those patients with a family member affected by an eating disorder could be of clinical utility.
神经性厌食症(AN)是一种复杂的疾病,其发病机制涉及生物和环境因素。本研究的目的是回顾性分析年轻 AN 患者的危险因素,并评估有无创伤后应激障碍(PTSD)诊断以及有无公认危险因素史的患者之间在临床和饮食相关症状方面的差异。
招募了 64 名年龄<25 岁的 AN 患者,并完成了病史评估和以下自评量表:饮食障碍问卷(EDE-Q)、童年创伤问卷(CTQ)、状态特质焦虑量表(STAI-Y)、贝克抑郁量表(BDI)、生活事件检查表(LEC)和分离体验量表(DES)。PTSD 诊断根据 DSM-5 结构临床访谈(SCID-5)确定。
最常见的危险因素与关系创伤事件和熟悉精神障碍有关。与无 PTSD 诊断的患者相比,有 PTSD 的患者出现了更严重的与身体相关的症状(即影响身体形象和感知并导致身体担忧的症状);然而,在控制了分离症状后,只有 BMI 的差异仍然显著。关于其他危险因素,有童年创伤史的患者比没有童年创伤史的患者抑郁程度更高,而熟悉饮食障碍的患者过去住院治疗 AN 的次数比不熟悉的患者更多。
这些结果表明,在 AN 患者中调查危险因素和 PTSD 诊断的重要性,以及治疗年轻患者的创伤后症状,以降低发展为严重 AN 的风险。此外,特别关注那些有家庭成员受饮食障碍影响的患者可能具有临床意义。