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饮食和喂养障碍患者的非自杀性自伤行为:一组转诊的女性青少年的特征及临床意义

Non-Suicidal Self-Injury in Eating and Feeding Disorder Patients: Characteristics and Clinical Implications in a Group of Referred Female Adolescents.

作者信息

Sesso Gianluca, Mazzullo Cristina, Valente Elena, Ditaranto Francesca, Fantozzi Pamela, Belmonti Vittorio, Berloffa Stefano, Placini Francesca, Tancredi Raffaella, Masi Gabriele, Milone Annarita

机构信息

Social and Affective Neuroscience Group, Molecular Mind Lab, IMT School for Advanced Studies, Piazza San Francesco, 55100 Lucca, Italy.

Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Viale del Tirreno 331, 56128 Pisa, Italy.

出版信息

Children (Basel). 2024 Aug 6;11(8):947. doi: 10.3390/children11080947.

Abstract

BACKGROUND

Non-suicidal self-injury (NSSI) and Feeding or Eating Disorders (FEDs) often coexist during adolescence with reciprocal influences on their clinical picture. The present study aimed to identify differences and similarities in the clinical presentation of young patients with both conditions compared to those with the two non-comorbid disorders.

METHODS

We consecutively recruited forty-five female patients aged between 11 and 18 at our third-level hospital and subdivided them into three groups (NSSI: n = 15; FED: n = 15; NSSI + FED: n = 15). Patients underwent a full clinical assessment.

RESULTS

Based on our results, the NSSI + FED group was characterized by higher rates of binging/purging behaviors, greater prevalence of Cyclothymic Disorder, and a more severe clinical presentation compared to the non-comorbid groups. Moreover, higher levels of suicidal ideation were found in the NSSI + FED group. Pharmacological treatment patterns also differed, with SSRI being prescribed more frequently to NSSI + FED patients while mood stabilizers were prescribed more frequently to NSSI ones. A Principal Component Analysis identified four main dimensions: "Body Image" impairment was more pronounced in NSSI + FED patients, indicating negative attitudes towards their own body; "Metacognition" deficits were higher in NSSI than FED.

CONCLUSIONS

The present study underscores distinctive clinical features in patients with comorbid NSSI and FED, emphasizing the urgent need for tailored intervention strategies focusing on specific symptom domains.

摘要

背景

非自杀性自伤(NSSI)和进食障碍(FEDs)在青少年时期常并存,且对彼此的临床表现有相互影响。本研究旨在确定同时患有这两种疾病的年轻患者与患有两种非共病疾病的患者在临床表现上的差异和相似之处。

方法

我们在三级医院连续招募了45名年龄在11至18岁之间的女性患者,并将她们分为三组(NSSI:n = 15;FED:n = 15;NSSI + FED:n = 15)。患者接受了全面的临床评估。

结果

根据我们的研究结果,与非共病组相比,NSSI + FED组的暴饮暴食/清除行为发生率更高,环性心境障碍的患病率更高,临床表现更严重。此外,NSSI + FED组的自杀意念水平更高。药物治疗模式也有所不同,NSSI + FED患者更频繁地使用选择性5-羟色胺再摄取抑制剂(SSRI),而NSSI患者更频繁地使用心境稳定剂。主成分分析确定了四个主要维度:“身体意象”损害在NSSI + FED患者中更为明显,表明他们对自己身体持消极态度;NSSI患者的“元认知”缺陷高于FED患者。

结论

本研究强调了NSSI和FED共病患者的独特临床特征,强调迫切需要针对特定症状领域制定量身定制的干预策略。

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Worldwide prevalence of DSM-5 eating disorders among young people.全球年轻人中 DSM-5 进食障碍的患病率。
Curr Opin Psychiatry. 2022 Nov 1;35(6):362-371. doi: 10.1097/YCO.0000000000000818. Epub 2022 Sep 13.

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