Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.
Int J Eat Disord. 2024 Oct;57(10):2006-2040. doi: 10.1002/eat.24280. Epub 2024 Oct 25.
To compare all other specified feeding or eating disorders (OSFED) groups (atypical anorexia nervosa [AN], purging disorder [PD], night eating syndrome [NES], subthreshold bulimia nervosa [sub-BN], and subthreshold binge-eating disorder [sub-BED]) to threshold eating disorders (EDs [AN, BN, and BED]) and control groups (CGs) on measures of eating and general psychopathology.
We conducted a comprehensive search in PsycINFO, Medline, Embase, and CINAHL on all published studies from January 2013 to February 2024 using DSM-5 diagnostic criteria via clinical interviews or well-established diagnostic tools. We also undertook a quality appraisal using an adapted version of the Downs and Black criteria and registered the review with PROSPERO (ID: CRD42022314495).
Overall, our meta-analyses (n = 33 eligible studies) indicated that the combined OSFED and several specific OSFED subtypes displayed comparable levels of eating psychopathology to full-threshold EDs. Our systematic review (n = 33 eligible studies) found individuals with OSFED to have comparable levels of eating and general psychopathology to full-threshold EDs, but higher levels of eating and general psychopathology than CGs. These findings were specifically attributed to atypical AN and NES. There was a lack of evidence available for sub-BN and sub-BED. Studies mainly met the quality appraisal criteria. The main limitations identified in the included studies were insufficient reporting of their statistical power (78%) and no adjusting for potential confounding factors (67%).
Findings support the conceptualization of atypical AN, and NES as clinically significant EDs with similar severity to full-threshold EDs.
将所有其他特定的喂养或进食障碍（OSFED）组（非典型神经性厌食症[AN]、清除障碍[PD]、夜间进食综合征[NES]、阈下神经性贪食症[sub-BN]和阈下暴食障碍[sub-BED]）与阈值进食障碍（EDs [AN、BN 和 BED]）和对照组（CGs）进行比较，以评估进食和一般心理病理情况。
我们通过临床访谈或经过验证的诊断工具，使用 DSM-5 诊断标准，对 2013 年 1 月至 2024 年 2 月发表的所有研究进行了综合搜索，研究结果发表在 PsycINFO、Medline、Embase 和 CINAHL 上。我们还使用 Downs 和 Black 标准的改编版进行了质量评估，并在 PROSPERO 上注册了该综述（ID：CRD42022314495）。
总的来说，我们的荟萃分析（n=33 项符合条件的研究）表明，综合 OSFED 和几种特定的 OSFED 亚型与完全阈值 ED 相比，具有相似的进食心理病理水平。我们的系统综述（n=33 项符合条件的研究）发现，OSFED 个体与完全阈值 ED 相比，具有相似的进食和一般心理病理水平，但比 CGs 更高。这些发现主要归因于非典型 AN 和 NES。目前尚无关于 sub-BN 和 sub-BED 的证据。这些研究主要符合质量评估标准。纳入研究中存在的主要局限性是缺乏对其统计功效的充分报告（78%），以及没有对潜在混杂因素进行调整（67%）。
研究结果支持将非典型 AN 和 NES 概念化为具有类似严重程度的临床显著 ED。
