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儿童进食障碍的患病率、预测因素和治疗:一项全国性研究。

Prevalence, predictors, and treatment of eating disorders in children: a national study.

机构信息

Department of Psychology, University at Albany, State University of New York, Albany, NY, USA.

Massachusetts General Hospital, Boston, MA, USA.

出版信息

Psychol Med. 2023 May;53(7):2974-2981. doi: 10.1017/S0033291721004992. Epub 2021 Dec 15.

Abstract

BACKGROUND

Although the prevalence rates of preadolescent eating disorders (EDs) are on the rise, considerably less is known about the correlates and treatment of EDs in this age group. Clarifying the epidemiology of EDs in preadolescent children is a necessary first step to understand the nature and scope of this problem in this age group.

METHODS

Analysis of data collected in the ABCD Study release 2.0.1. The ABCD cohort was a population-based sample that consisted of 11 721 children ages 9-10 years. Measures included reports of a lifetime and current mental disorders determined using a diagnostic interview for DSM-5 disorders, sociodemographic factors, and psychiatric treatment utilization.

RESULTS

The lifetime prevalence of EDs was 0.95%. Being Black, multiracial, having unmarried parents, and family economic insecurity were significant predictors for developing an ED. Among psychiatric conditions, the major depressive disorder was most robustly associated with EDs in both cross-sectional and temporal analyses. Only 47.40% of children who had a lifetime ED received some type of psychiatric treatment. EDs were not a significant predictor of psychiatric treatment utilization after accounting for sex, sexual orientation, parent marital status, economic insecurity, and all other psychiatric diagnoses.

CONCLUSIONS

Despite increasing prevalence rates of preadolescent EDs, the current findings suggest that the majority of children with these disorders remain untreated. Devoting increased attention and resources to reaching families of children with EDs with the least means for receiving care, and screening for EDs in children with depression, may be important steps for reducing this unmet need.

摘要

背景

尽管青春期前饮食失调症(ED)的患病率正在上升,但对于该年龄段 ED 的相关因素和治疗方法知之甚少。明确青春期前儿童 ED 的流行病学情况是了解该年龄段这一问题性质和范围的必要的第一步。

方法

对 ABCD 研究发布 2.0.1 版中收集的数据进行分析。ABCD 队列是一个基于人群的样本,包括 11721 名 9-10 岁的儿童。评估措施包括使用 DSM-5 障碍诊断访谈来确定的终生和当前精神障碍报告、社会人口因素和精神科治疗的使用情况。

结果

ED 的终生患病率为 0.95%。黑人和多种族、父母未婚、家庭经济不稳定是发生 ED 的显著预测因素。在精神疾病中,重度抑郁症在横断面和时间分析中与 ED 最密切相关。只有 47.40%有过 ED 病史的儿童接受了某种形式的精神科治疗。在考虑到性别、性取向、父母婚姻状况、经济不稳定和所有其他精神科诊断后,ED 并不是精神科治疗利用的显著预测因素。

结论

尽管青春期前 ED 的患病率不断上升,但目前的研究结果表明,大多数患有这些疾病的儿童未得到治疗。为了让最没有条件接受治疗的 ED 患儿家庭得到更多的关注和资源,以及为患有抑郁症的儿童筛查 ED,可能是减少这一未满足需求的重要步骤。

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