精神病临床高危个体的饮食失调及紊乱饮食症状：一项系统评价与荟萃分析
Eating disorders and disordered eating symptoms in individuals at clinical high risk for psychosis: a systematic review and meta-analysis.
作者信息
Lo Buglio Gabriele, Mirabella Marta, Muzi Laura, Boldrini Tommaso, Cerasti Erika, Bjornestad Jone, Fiorentino Flavia, Polari Andrea, Riccioli Eleonora, Rugo Michele Angelo, Solmi Marco, Lingiardi Vittorio, Tanzilli Annalisa
机构信息
Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy.
出版信息
Eat Weight Disord. 2024 Dec 27;29(1):78. doi: 10.1007/s40519-024-01708-x.
BACKGROUND
Eating disorders (EDs) are among the least studied mental disorders in individuals at clinical high risk for psychosis (CHR-P). The primary aim (a) of this systematic review and meta-analysis was to identify factors predicting ED diagnoses in CHR-P individuals. The secondary aim (b) was providing a comprehensive clinical description of individuals with both CHR-P and EDs/ED-related symptoms.
METHODS
Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020-compliant systematic review and meta-analysis, searching PubMed/(EBSCO)PsycINFO/Web of Science for studies published between 01/01/2018 and 30/05/2023, including individuals with CHR-P and EDs/ED symptoms (PROSPERO CRD42023488792). Quality assessment was performed using the Newcastle-Ottawa Scale (NOS). We performed a meta-regression model on the proportion of EDs in CHR-P individuals (primary aim) and conducted a narrative synthesis (secondary aim).
RESULTS
We included 26 articles, reporting on 2,060 and 589 subjects for study aim (a) and (b), respectively (mean NOS score = 6.38). The prevalence of EDs in CHR-P individuals was 0.05 (95% CI 0.3-0.8). No factor had a significant effect on the proportion of EDs in CHR-P individuals. This result is limited by the inability to include ED-related symptoms and antipsychotic prescriptions in the meta-regression model, due to an insufficient number of studies reporting on these variables. The narrative synthesis offers a characterization of individuals with both CHR-P and ED/ED-related symptoms; however, the limited number of included studies is insufficient to support definitive conclusions.
CONCLUSIONS
No significant predictor of EDs was found in CHR-P individuals. Transdiagnostic, prospective cohort studies are warranted to examine long-term outcomes in individuals with both CHR-P and EDs, beyond diagnostic silos.
LEVEL OF EVIDENCE
I. Systematic review and meta-analysis.
背景
饮食失调（EDs）是临床高危精神病个体（CHR-P）中研究最少的精神障碍之一。本系统评价和荟萃分析的主要目的（a）是确定预测CHR-P个体饮食失调诊断的因素。次要目的（b）是对患有CHR-P和饮食失调/饮食失调相关症状的个体进行全面的临床描述。
方法
按照系统评价和荟萃分析的首选报告项目（PRISMA）2020进行系统评价和荟萃分析，在PubMed/（EBSCO）PsycINFO/科学网中检索2018年1月1日至2023年5月30日发表的研究，纳入患有CHR-P和饮食失调/饮食失调症状的个体（PROSPERO注册号：CRD42023488792）。使用纽卡斯尔-渥太华量表（NOS）进行质量评估。我们对CHR-P个体中饮食失调的比例进行了荟萃回归模型分析（主要目的），并进行了叙述性综合分析（次要目的）。
结果
我们纳入了分别针对研究目的（a）和（b）报告2060名和589名受试者的26篇文章（平均NOS评分为6.38）。CHR-P个体中饮食失调的患病率为0.05（95%可信区间0.3-0.8）。没有因素对CHR-P个体中饮食失调的比例有显著影响。由于报告这些变量的研究数量不足，该结果受到无法将饮食失调相关症状和抗精神病药物处方纳入荟萃回归模型的限制。叙述性综合分析提供了对患有CHR-P和饮食失调/饮食失调相关症状个体的特征描述；然而，纳入研究数量有限，不足以支持确定性结论。
结论
在CHR-P个体中未发现饮食失调的显著预测因素。有必要开展跨诊断的前瞻性队列研究，以研究同时患有CHR-P和饮食失调的个体的长期结局，超越诊断范畴。
证据水平
I. 系统评价和荟萃分析。
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