Vaidyanathan Sivapriya, Menon Vikas
Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Indian J Psychiatry. 2024 Jan;66(1):9-25. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_782_23. Epub 2024 Jan 25.
Despite growing evidence of their prevalence, research on feeding and eating disorders (FEDs) in India has been sporadic. This narrative review aimed to summarize the research on FED in India and set priorities for future research and translation of evidence. An electronic search was conducted in the MEDLINE, PsycINFO, and Google Scholar databases to identify relevant English peer-reviewed articles from April 1967 to July 2023. The extracted data from these studies included author names, publication year, research location, type of intervention (for interventional studies), nature of comparator treatments, and main outcomes or findings. We found a rising trend in the prevalence of EDs in India. Adolescent age group, female sex, higher socioeconomic status, family history of mental illness or disordered eating, and borderline personality pattern were risk factors for EDs. For feeding disorders (FDs), childhood age group, malnutrition, pregnancy, psychosis, intellectual disability (ID), and obsessive-compulsive disorder (OCD) were putative risk factors. Both physical and psychiatric comorbidities were common in FEDs. Culture appears to exert a pathoplastic effect on symptom presentation in FEDs; an illustrative example is the documented nonfat phobic variant of anorexia nervosa (AN) in India. Research on management has focused on using assessment tools, investigations to rule out medical comorbidities, psychosocial and family-based psychotherapies, nutritional rehabilitation, pharmacotherapy, and neuromodulation approaches. Whereas the publication output on FEDs in India has increased over the last decade, it remains an under-researched area, with a striking paucity of original research. Future research priorities in FEDs include conducting country-wide registry-based studies to offer real-world insights, longitudinal research to identify culturally relevant risk factors, and developing brief, culturally sensitive diagnostic instruments for FEDs in the Indian context. This will help generate locally relevant epidemiological data on FEDs and inform treatment and prevention strategies.
尽管有越来越多的证据表明饮食失调症在印度普遍存在,但对其的研究却很零散。本叙述性综述旨在总结印度饮食失调症的研究情况,并为未来研究及证据转化确定优先事项。我们在MEDLINE、PsycINFO和谷歌学术数据库中进行了电子检索,以识别1967年4月至2023年7月间相关的英文同行评审文章。从这些研究中提取的数据包括作者姓名、发表年份、研究地点、干预类型(针对干预性研究)、对照治疗的性质以及主要结果或发现。我们发现印度饮食失调症的患病率呈上升趋势。青少年年龄组、女性、较高的社会经济地位、精神疾病或饮食失调家族史以及边缘型人格模式是饮食失调症的危险因素。对于喂养障碍,儿童年龄组、营养不良、怀孕、精神病、智力残疾和强迫症是假定的危险因素。身体和精神共病在饮食失调症中都很常见。文化似乎对饮食失调症的症状表现具有塑形作用;一个例证是印度记录在案的神经性厌食症(AN)的非脂肪恐惧症变体。管理方面的研究集中在使用评估工具、排除医学共病的检查、心理社会和基于家庭的心理治疗、营养康复、药物治疗以及神经调节方法。尽管印度在饮食失调症方面的出版物数量在过去十年有所增加,但它仍然是一个研究不足的领域,原创研究非常匮乏。饮食失调症未来的研究重点包括开展基于全国登记处的研究以提供真实世界的见解、进行纵向研究以确定与文化相关的危险因素,以及在印度背景下开发针对饮食失调症的简短且对文化敏感的诊断工具。这将有助于生成与当地相关的饮食失调症流行病学数据,并为治疗和预防策略提供依据。