Graduate School of Social Work, University of Denver, Denver, Colorado, USA.
School of Social Work, University of Washington, Seattle, Washington, USA.
Int J Eat Disord. 2021 Aug;54(8):1328-1357. doi: 10.1002/eat.23519. Epub 2021 Apr 17.
Currently, there is debate in the eating disorders field regarding how to define atypical anorexia (AAN), how prevalent it is in community and clinical settings, and how AAN rates compare with low-weight AN. This systematic review assesses AAN literature from 2007 to 2020, to investigate: (a) the demographic characteristics of AAN studies, (b) the prevalence of AAN compared with AN, (c) the range of operational definitions of AAN and the implications of these definitions, and (d) the proportion of patients with AAN and AN represented in consecutive admission and referral samples.
PsychINFO, CINAHL, PubMed, Greylit.org, and ProQuest databases were searched according to methods for Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic reviews, yielding 3,184 potential articles. Seventy-five eligible studies were coded for sixty-one variables.
Clinical samples predominantly included younger, female, white samples with limited diversity. In epidemiological designs, AAN was typically as common or more common than AN, and AAN rates varied significantly based on the population studied and operational definitions. In consecutive clinical samples, AAN was frequently less represented.
Although AAN appears to occur more frequently than AN in communities, fewer patients with AAN are being referred and admitted to eating disorder specific care, particularly in the United States. Given the significant medical and psychosocial consequences of AAN, and the importance of early intervention, this represents a crucial treatment gap. Additionally, results suggest the need for fine-tuning diagnostic definitions, greater diversity in AAN studies, and increased screening and referral for this vulnerable population.
目前，在饮食失调领域存在关于如何定义非典型性厌食症（AAN）、它在社区和临床环境中的普遍程度以及 AAN 发生率与低体重 AN 相比如何的争论。本系统评价评估了 2007 年至 2020 年的 AAN 文献，以调查：（a）AAN 研究的人口统计学特征，（b）AAN 与 AN 的患病率比较，（c）AAN 的操作定义范围及其定义的含义，以及（d）AAN 和 AN 患者在连续入院和转介样本中的比例。
根据系统评价和荟萃分析的首选报告项目方法，在 PsychINFO、CINAHL、PubMed、Greylit.org 和 ProQuest 数据库中进行搜索，产生了 3184 篇潜在文章。对 75 项符合条件的研究进行了 61 个变量的编码。
临床样本主要包括年轻、女性、白人，且多样性有限。在流行病学设计中，AAN 通常与 AN 一样常见或更常见，并且 AAN 的发生率因研究人群和操作定义的不同而有很大差异。在连续的临床样本中，AAN 的代表性较低。
尽管 AAN 在社区中似乎比 AN 更常见，但患有 AAN 的患者被转介和收治到饮食失调特定治疗的比例较低，特别是在美国。鉴于 AAN 的严重医疗和心理社会后果，以及早期干预的重要性，这代表了一个关键的治疗差距。此外，结果表明需要微调诊断定义、增加 AAN 研究的多样性，并增加对这一弱势群体的筛查和转介。
