Pruccoli Jacopo, Chiavarino Francesca, Valeriani Beatrice, Petio Maria Letizia, Parmeggiani Antonia
IRCCS Istituto delle Scienze Neurologiche di Bologna, Regional Center for Feeding and Eating Disorders in the Developmental Age, Child Neurology and Psychiatry Unit, 40138 Bologna, Italy.
Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy.
Pediatr Rep. 2024 Jul 16;16(3):579-593. doi: 10.3390/pediatric16030049.
This study aimed to comprehensively report the epidemiological and clinical features of atypical anorexia nervosa (AAN) in children and adolescents.
In May 2024, a systematic review was performed using Medline, Cochrane Library, ClinicalTrials.gov, and relevant websites. Following PRISMA guidelines, 234 articles were screened for studies on DSM-5-defined AAN. A standardized checklist-the JBI critical appraisal tool-was adopted in assessing methodology, and 13 retained studies passed the screening and critical appraisal process for the final review. The Newcastle-Ottawa Scale was utilized to assess the risk of bias in cohort and case-control studies, ensuring a comprehensive evaluation of methodological quality.
AAN prevalence in young age groups is 2.8%, with a cumulative 2.8% incidence over 8 years. Incidence is 366 per 100,000 person-years, and the average episode duration is 11.6 months, with a 71% remission rate. Diagnostic persistence for AAN is less stable than other restrictive feeding and eating disorders (FEDs). AAN individuals exhibit higher EDE-Q scores, more severe distress, and distinct BMI differences compared to those with anorexia nervosa and controls. The diagnostic transition from the DSM-IV to the DSM-5 shows that AAN patients are predominantly female, slightly older, and with higher weight.
This study yields concrete insights into the features of AAN in the developmental age, highlighting demographic variations, clinical presentations, and treatment outcomes. Recognizing the unique challenges faced by AAN individuals is vital for tailoring effective interventions and improving overall care within the FED spectrum.
本研究旨在全面报告儿童和青少年非典型神经性厌食症（AAN）的流行病学和临床特征。
2024年5月，使用Medline、Cochrane图书馆、ClinicalTrials.gov及相关网站进行了系统评价。按照PRISMA指南，筛选了234篇关于DSM-5定义的AAN的研究。采用标准化清单——JBI批判性评价工具来评估方法学，并对13项纳入研究进行筛选和批判性评价以进行最终评审。使用纽卡斯尔-渥太华量表评估队列研究和病例对照研究中的偏倚风险，以全面评估方法学质量。
年轻年龄组中AAN的患病率为2.8%，8年累计发病率为2.8%。发病率为每10万人年366例，平均发作持续时间为11.6个月，缓解率为71%。AAN的诊断持续性比其他限制性喂养和进食障碍（FEDs）更不稳定。与神经性厌食症患者和对照组相比，AAN患者的EDE-Q评分更高、痛苦更严重且BMI差异明显。从DSM-IV到DSM-5的诊断转变表明，AAN患者以女性为主，年龄稍大，体重更高。
本研究对发育年龄阶段AAN的特征提供了具体见解，突出了人口统计学差异、临床表现和治疗结果。认识到AAN患者面临的独特挑战对于制定有效的干预措施和改善FED范围内的整体护理至关重要。
