Child and Adolescent Mental Health Department, University of Milan Bicocca, S. Gerardo Hospital, ASST of Monza, Via Pergolesi, 33, 20900, Monza, Italy.
Eat Weight Disord. 2022 Jun;27(5):1729-1737. doi: 10.1007/s40519-021-01311-4. Epub 2021 Sep 29.
Anorexia nervosa (AN) and non-suicidal self-injury (NSSI) share typical onset in adolescence, greater prevalence in females and similar risk factors. Nevertheless, clinical features of eating disorders (ED) in this population are still under-investigated, especially associated to psychological features.
The present study aims at comparing clinical and ED characteristics and psychopathological traits in a sample of 253 female adolescents with AN with or without NSSI and to determine possible clinical and psychological predictors on the presence of NSSI. The two groups were compared through multivariate analyses, while correlation and regression analyses were conducted to determine possible associations and predictors.
AN + NSSI group showed higher prevalence of binging-purging-type AN (p < .001), and mean higher age (p = .008) and Body Mass Index (BMI) (p = .002) than AN without NSSI group. Concerning psychological scales, AN + NSSI group showed higher scores in mostly of the sub-scale of the test Eating Disorders Inventory-3, higher scores at the scale for depression (p < 0.001) and higher scores at the three indexes of Symptom Checklist 90-Revised test, Global Severity Index (p < 0.001), Positive Symptoms total (p = .003) and Positive Symptom Distress Index (p < 0.001). No differences emerged at Children's Global Assessment Scale and at scale for evaluation of alexithymia. Regression analyses showed that a diagnosis of binging-purging-type AN (p = .001) predicts NSSI.
Results suggest that adolescents with AN and NSSI show peculiar clinical features with higher prevalence of binging-purging-type AN and more severe psychopathological traits than adolescents with AN without NSSI.
Level III: Evidence obtained from cohort or case-control analytic studies.
神经性厌食症(AN)和非自杀性自伤(NSSI)在青少年时期的发病典型,女性的发病率更高,且具有相似的风险因素。尽管如此,该人群中饮食失调(ED)的临床特征仍未得到充分研究,尤其是与心理特征相关的临床特征。
本研究旨在比较 253 名患有 AN 且伴有或不伴有 NSSI 的女性青少年患者的临床和 ED 特征以及精神病理特征,并确定 NSSI 存在的可能临床和心理预测因素。通过多元分析比较两组,同时进行相关性和回归分析,以确定可能的关联和预测因素。
AN+NSSI 组的暴食-清肠型 AN 患病率更高(p<0.001),且平均年龄更高(p=0.008)和体重指数(BMI)更高(p=0.002),而无 NSSI 的 AN 组则较低。就心理量表而言,AN+NSSI 组在 Eating Disorders Inventory-3 的大多数子量表中得分更高,在抑郁量表中得分更高(p<0.001),在 Symptom Checklist 90-Revised 测试的三个指标中得分更高,即总体严重程度指数(p<0.001)、阳性症状总分(p=0.003)和阳性症状痛苦指数(p<0.001)。在儿童总体评估量表和评估述情障碍量表上无差异。回归分析表明,暴食-清肠型 AN 的诊断(p=0.001)可预测 NSSI。
结果表明,患有 AN 和 NSSI 的青少年具有特殊的临床特征,其暴食-清肠型 AN 的患病率更高,且心理病理特征更严重,而非患有 AN 但不伴有 NSSI 的青少年。
三级:来自队列或病例对照分析研究的证据。