澳大利亚儿童早发性进食障碍：一项全国性监测研究显示发病率上升。
Early-onset eating disorders in Australian children: A national surveillance study showing increased incidence.
机构信息
The Australian Paediatric Surveillance Unit, The University of Sydney, Sydney, New South Wales, Australia.
Faculty of Medicine and Health, Discipline of Child and Adolescent Health and Paediatrician, The Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.
出版信息
Int J Eat Disord. 2022 Dec;55(12):1838-1842. doi: 10.1002/eat.23794. Epub 2022 Aug 17.
OBJECTIVE
The aim of this study was to collect prospective national data on early-onset eating disorders (EOEDs) in children in Australia to document changes in clinical presentations, medical complications, management, and incidence since initially described in 2002-2005.
METHOD
Each month pediatricians reported children aged 5-13 years newly diagnosed with an eating disorder to the Australian Paediatric Surveillance Unit and provided de-identified clinical data.
RESULTS
Between 2016 and 2018, 184 children were confirmed with EOED with a minimum estimated national incidence of 2.79 per 100,000 children aged 5-13 years (95% confidence interval [CI] 2.40-3.23), nearly double the previously recorded incidence. The mean age at diagnosis was 12.2 years; 43(24%) were boys who were younger than girls (11.85 vs. 12.33 years; p = .03). All had food avoidance. Common symptoms included fear of weight gain 140 (76%), preoccupation with body weight 134 (73%), and misperception of body size 116 (63%). Bradycardia was present in 83 (45%) and 117 (64%) who required hospital admission. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5) criteria for anorexia nervosa were met for 144 (78%).
DISCUSSION
Children with eating disorders continue to present with severe illness. Near doubling in incidence in just over a 10-year period highlights the need for increased clinical resourcing and comparable international data.
PUBLIC SIGNIFICANCE
The incidence of new presentations of eating disorders in children aged 5-13 years has nearly doubled since a similar study was conducted over 10 years ago. Children were unwell for an average of 8 months before diagnosis; approximately 80% had a clear diagnosis of anorexia nervosa and 64% needed hospital admission due to medical complications. This highlights the need for improvements in education and clinical resources for this age group.
目的
本研究旨在收集澳大利亚儿童早发性进食障碍（EOED）的前瞻性全国数据，记录自 2002-2005 年首次描述以来临床表现、医疗并发症、管理和发病率的变化。
方法
每月儿科医生向澳大利亚儿科监测单位报告新诊断为进食障碍的 5-13 岁儿童，并提供匿名临床数据。
结果
2016 年至 2018 年间，共确诊 184 例 EOED，全国估计发病率最低为每 100,000 名 5-13 岁儿童 2.79 例（95%置信区间 [CI] 2.40-3.23），几乎是之前记录发病率的两倍。诊断时的平均年龄为 12.2 岁；43 名（24%）为男孩，比女孩小（11.85 岁比 12.33 岁；p=0.03）。所有患儿均有食物回避。常见症状包括 140 例（76%）对体重增加的恐惧、134 例（73%）对体重的过分关注和 116 例（63%）对身体大小的误解。83 例（45%）和 117 例（64%）患儿出现心动过缓，需要住院治疗。符合《精神障碍诊断与统计手册》第五版修订版（DSM-5）神经性厌食症标准的患儿为 144 例（78%）。
讨论
进食障碍患儿仍表现出严重疾病。在短短 10 年多的时间里，发病率几乎翻了一番，这突显了增加临床资源和获取可比国际数据的必要性。
公众意义
自 10 多年前进行类似研究以来，5-13 岁儿童新出现进食障碍的发病率几乎翻了一番。患儿平均在被诊断前患病 8 个月；约 80%明确诊断为神经性厌食症，64%因医疗并发症需要住院治疗。这凸显了需要改善该年龄段的教育和临床资源。
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