饮食失调的精神和医学共病：文献快速综述的结果
Psychiatric and medical comorbidities of eating disorders: findings from a rapid review of the literature.
作者信息
Hambleton Ashlea, Pepin Genevieve, Le Anvi, Maloney Danielle, Touyz Stephen, Maguire Sarah
机构信息
InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre (D17), University of Sydney, Camperdown, NSW, 2006, Australia.
School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia.
出版信息
J Eat Disord. 2022 Sep 5;10(1):132. doi: 10.1186/s40337-022-00654-2.
BACKGROUND
Eating disorders (EDs) are potentially severe, complex, and life-threatening illnesses. The mortality rate of EDs is significantly elevated compared to other psychiatric conditions, primarily due to medical complications and suicide. The current rapid review aimed to summarise the literature and identify gaps in knowledge relating to any psychiatric and medical comorbidities of eating disorders.
METHODS
This paper forms part of a rapid review) series scoping the evidence base for the field of EDs, conducted to inform the Australian National Eating Disorders Research and Translation Strategy 2021-2031, funded and released by the Australian Government. ScienceDirect, PubMed and Ovid/Medline were searched for English-language studies focused on the psychiatric and medical comorbidities of EDs, published between 2009 and 2021. High-level evidence such as meta-analyses, large population studies and Randomised Control Trials were prioritised.
RESULTS
A total of 202 studies were included in this review, with 58% pertaining to psychiatric comorbidities and 42% to medical comorbidities. For EDs in general, the most prevalent psychiatric comorbidities were anxiety (up to 62%), mood (up to 54%) and substance use and post-traumatic stress disorders (similar comorbidity rates up to 27%). The review also noted associations between specific EDs and non-suicidal self-injury, personality disorders, and neurodevelopmental disorders. EDs were complicated by medical comorbidities across the neuroendocrine, skeletal, nutritional, gastrointestinal, dental, and reproductive systems. Medical comorbidities can precede, occur alongside or emerge as a complication of the ED.
CONCLUSIONS
This review provides a thorough overview of the comorbid psychiatric and medical conditions co-occurring with EDs. High psychiatric and medical comorbidity rates were observed in people with EDs, with comorbidities contributing to increased ED symptom severity, maintenance of some ED behaviours, and poorer functioning as well as treatment outcomes. Early identification and management of psychiatric and medical comorbidities in people with an ED may improve response to treatment and overall outcomes.
背景
饮食失调是潜在的严重、复杂且危及生命的疾病。与其他精神疾病相比，饮食失调的死亡率显著升高，主要原因是医学并发症和自杀。本次快速综述旨在总结相关文献，并找出饮食失调的任何精神和医学共病方面的知识空白。
方法
本文是一系列快速综述的一部分，该系列综述了饮食失调领域的证据基础，旨在为澳大利亚政府资助并发布的《2021 - 2031年澳大利亚国家饮食失调研究与转化战略》提供信息。在科学Direct、PubMed和Ovid/Medline数据库中检索了2009年至2021年发表的、聚焦饮食失调精神和医学共病的英文研究。优先纳入荟萃分析、大型人群研究和随机对照试验等高等级证据。
结果
本综述共纳入202项研究，其中58%与精神共病相关，42%与医学共病相关。总体而言，饮食失调最常见的精神共病是焦虑（高达62%）、情绪障碍（高达54%）、物质使用障碍和创伤后应激障碍（相似的共病率高达27%）。该综述还指出了特定饮食失调与非自杀性自伤、人格障碍和神经发育障碍之间的关联。饮食失调会因神经内分泌、骨骼、营养、胃肠道、牙齿和生殖系统等方面的医学共病而变得复杂。医学共病可能先于饮食失调出现、与饮食失调同时发生或作为饮食失调的并发症出现。
结论
本综述全面概述了与饮食失调同时出现的精神和医学共病情况。饮食失调患者的精神和医学共病率较高，共病会导致饮食失调症状严重程度增加、某些饮食失调行为持续存在、功能状况变差以及治疗效果不佳。对饮食失调患者的精神和医学共病进行早期识别和管理，可能会改善治疗反应和总体预后。
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