The Danish Patient Association of Eating Disorders and Self-Harm, Valby, Denmark.
Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Int J Eat Disord. 2023 Oct;56(10):1947-1960. doi: 10.1002/eat.24023. Epub 2023 Jul 17.
Binge-eating disorder (BED) and subthreshold BED (SBED) are prevalent in adults and associated with mental health problems including depression, non-suicidal self-injury, lower quality of life, and suicidality. There is solid evidence that binge-eating behaviors are also prevalent in adolescence, but knowledge about mental health in community adolescents with BED of different frequency thresholds is more limited. We aimed to investigate the prevalence and mental health problems associated with SBED of low frequency and/or limited duration compared with BED in a Danish community sample of adolescents.
We included 2509 adolescents who completed the online survey of the 16-17-year follow-up of the Copenhagen Child Cohort (CCC2000), including items on BED symptoms approximating the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, and items on mental health and quality of life.
The 1-year prevalence of SBED was 2.7% (95% confidence interval [CI]: 2.0%-3.3%) with a male:female ratio of 1:3.7; comparable to previous findings on BED in the same sample. SBED was also comparable to BED concerning cross-sectional associations with overall mental health problems, lower health-related quality of life, depressive symptoms, and suicidal ideation, whereas no associations were seen with non-suicidal self-injury after Holm-Bonferroni correction. In both groups, thoughts and behaviors concerning food and weight interfered significantly with daily life.
SBED and BED were equally prevalent in this adolescent community sample, and similarly associated with indicators of poor mental health. The findings indicate that community adolescents reporting symptoms approximating clinical criteria of BED need intervention irrespectively of symptom frequency or duration.
This study adds knowledge to the field by comparing BED of low frequency and/or limited duration ("subthreshold BED," SBED) with full-syndrome BED in adolescents and showing that SBED in adolescence is both prevalent and associated with poor mental health to a similar extent as that of BED. Findings indicate that self-reported symptoms according to clinical criteria of SBED and BED alike constitute a public health problem and point to youngsters in need of intervention.
暴食障碍（BED）和阈下暴食障碍（SBED）在成年人中普遍存在，与心理健康问题相关，包括抑郁、非自杀性自伤、生活质量下降和自杀意念。有确凿的证据表明，暴食行为在青少年中也很普遍，但对于不同频率阈值的 BED 社区青少年的心理健康知识更为有限。我们旨在研究丹麦社区青少年中，与 BED 相比，低频率和/或有限持续时间的 SBED 的流行程度以及与心理健康问题的关联。
我们纳入了 2509 名完成哥本哈根儿童队列（CCC2000）16-17 岁随访的在线调查的青少年，其中包括了接近《精神障碍诊断与统计手册》（DSM-5）标准的 BED 症状项目，以及心理健康和生活质量项目。
SBED 的 1 年患病率为 2.7%（95%置信区间[CI]：2.0%-3.3%），男：女比例为 1:3.7，与之前在同一样本中关于 BED 的发现相似。SBED 与 BED 同样存在横断面关联，与整体心理健康问题、较低的健康相关生活质量、抑郁症状和自杀意念相关，而在 Holm-Bonferroni 校正后，与非自杀性自伤无关。在这两个群体中，与食物和体重有关的想法和行为都会显著干扰日常生活。
在这个青少年社区样本中，SBED 和 BED 的患病率相当，并且与不良心理健康的指标相似相关。研究结果表明，报告接近 BED 临床标准的症状的社区青少年无论症状频率或持续时间如何，都需要干预。
本研究通过比较青少年中低频率和/或有限持续时间的 BED（“阈下 BED”，SBED）与全综合征 BED，增加了该领域的知识，并表明青少年中 SBED 的流行程度和与不良心理健康的关联程度与 BED 相似。研究结果表明，根据 SBED 和 BED 的临床标准报告的症状本身就是一个公共卫生问题，指向需要干预的青少年。
