Sjögren Magnus, Lichtenstein Mia Beck, Støving Rene Klinkby
Eating Disorder Research Unit, Psychiatric Center Ballerup, 2750 Ballerup, Denmark.
Institute for Clinical Science, Sundsvall Regional Hospital, Umeå University, 851 86 Sundsvall, Sweden.
J Pers Med. 2023 Apr 23;13(5):709. doi: 10.3390/jpm13050709.
The main characteristics of Anorexia Nervosa (AN) in adults are restriction of energy intake relative to requirements leading to significant weight loss, disturbed body image, and intense fear of becoming fat. Traumatic experiences (TE) have been reported as common, although less is known about the relationship with other symptoms in severe AN. We investigated the presence of TE, PTSD, and the relation between TE, eating disorder (ED) symptoms, and other symptoms in moderate to severe AN ( = 97) at admission to inpatient weight-restoration treatment. All patients were enrolled in the Prospective Longitudinal all-comer inclusion study on Eating Disorders (PROLED).
TE were assessed using the Post-traumatic stress disorder checklist, Civilian version (PCL-C), and ED symptoms using the Eating Disorder Examination Questionnaire (EDE-Q); depressive symptoms were assessed using the Major Depression Inventory (MDI), and the presence of Post-traumatic Stress Disorder (PTSD) was diagnosed according to ICD-10 criteria.
The mean score on PCL-C was high (mean 44.6 SD 14.7), with 51% having a PCL-C score at or above 44 ( = 49, suggested cut-off for PTSD), although only one individual was clinically diagnosed with PTSD. There was a positive correlation between baseline scores of PCL-C and EDE-Q-global score (r = 0.43; < 0.01) as well as of PCL-C and all EDE-Q subscores. None of the included patients were admitted for treatment of TE/PTSD during the first 8 weeks of treatment.
In a group of patients with moderate to severe AN, TE were common, and scores were high, although only one had a diagnosis of PTSD. TE were related to ED symptoms at baseline, but this association diminished during the weight restoration treatment.
成人神经性厌食症（AN）的主要特征是相对于需求而言能量摄入受限，导致显著体重减轻、身体形象紊乱以及对变胖的强烈恐惧。创伤经历（TE）据报道很常见，尽管对于其与重度AN中其他症状的关系了解较少。我们调查了在住院体重恢复治疗入院时，中度至重度AN患者（n = 97）中TE、创伤后应激障碍（PTSD）的存在情况，以及TE、进食障碍（ED）症状和其他症状之间的关系。所有患者均纳入进食障碍前瞻性纵向全人群纳入研究（PROLED）。
使用平民版创伤后应激障碍检查表（PCL-C）评估TE，使用进食障碍检查问卷（EDE-Q）评估ED症状；使用重度抑郁量表（MDI）评估抑郁症状，并根据ICD-10标准诊断创伤后应激障碍（PTSD）的存在情况。
PCL-C的平均得分较高（平均44.6，标准差14.7），51%的患者PCL-C得分等于或高于44（n = 49，PTSD的建议临界值），尽管只有1人被临床诊断为PTSD。PCL-C的基线得分与EDE-Q总体得分（r = 0.43；P < 0.01）以及PCL-C与所有EDE-Q子得分之间存在正相关。在治疗的前8周内，纳入的患者中没有一人因TE/PTSD接受治疗。
在一组中度至重度AN患者中，TE很常见且得分较高，尽管只有1人被诊断为PTSD。TE在基线时与ED症状相关，但这种关联在体重恢复治疗期间减弱。
