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神经性厌食症诊断前后的医学诊断模式:一项丹麦全国队列研究。

Patterns of Medical Diagnoses Before and After a Diagnosis of Anorexia Nervosa: A Danish Nationwide Cohort Study.

作者信息

Søeby Mette, Clausen Loa, Richelsen Bjørn, Gribsholt Sigrid Bjerge

机构信息

Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.

Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.

出版信息

Int J Eat Disord. 2025 Mar;58(3):624-634. doi: 10.1002/eat.24340. Epub 2025 Jan 6.


DOI:10.1002/eat.24340
PMID:39763082
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11891635/
Abstract

OBJECTIVE: This study investigates the overall pattern and timing of medical diagnoses up to 10 years before an anorexia nervosa (AN) diagnosis and explores differences before and after AN diagnosis aiming to improve early detection. METHOD: In this nationwide population-based cohort study, we included all patients diagnosed with incident AN from 1987 to 2018 (n = 13,345) and a 1:10 age- and sex-matched general population comparison cohort, using Danish health registries. Using conditional logistic regression, we calculated odds ratios (ORs) of medical diagnoses up to 10 years before AN diagnosis. Additionally, we calculated crude and adjusted hazard ratios (aHRs) for risk of medical diagnoses after AN diagnosis using Cox proportional hazards model. RESULTS: AN was associated with increased odds of any medical diagnosis up to 10 years before AN diagnosis: OR 1.3 [95% CI 1.2-1.3] and the odds increased during the 12 months preceding AN diagnosis: OR 1.6 [95% CI 1.5-1.7]. The medical diagnoses associated with the highest odds up to 10 years prior AN were malnutrition: OR 5.0 [95% CI 4.0-6.3] anemia: OR 2.9 [95% CI 2.3-3.6], amenorrhea: OR 2.7 [95% CI 2.3-3.2], and irritable bowel syndrome: OR 2.1 [95% CI 1.9-2.4]. The pre-diagnosis pattern mirrored the post-diagnosis pattern. CONCLUSION: The similarity in diagnosis patterns before and after AN diagnosis suggests that many patients receive medical diagnoses for conditions potentially linked to AN-related restricted eating, malnutrition and progressive weight loss even years prior to a formal AN diagnosis. Identifying these early conditions may enable earlier AN diagnosis and improve treatment outcomes.

摘要

目的:本研究调查神经性厌食症(AN)诊断前长达10年的医学诊断总体模式和时间,并探讨AN诊断前后的差异,旨在改善早期检测。 方法:在这项基于全国人群的队列研究中,我们使用丹麦健康登记系统,纳入了1987年至2018年期间所有确诊为新发AN的患者(n = 13345)以及按年龄和性别1:10匹配的普通人群对照队列。使用条件逻辑回归,我们计算了AN诊断前长达10年的医学诊断比值比(OR)。此外,我们使用Cox比例风险模型计算了AN诊断后医学诊断风险的粗风险比和调整后风险比(aHR)。 结果:AN与AN诊断前长达10年的任何医学诊断几率增加相关:OR为1.3 [95% CI 1.2 - 1.3],且在AN诊断前的12个月内几率增加:OR为1.6 [95% CI 1.5 - 1.7]。在AN诊断前长达10年与最高几率相关的医学诊断为营养不良:OR为5.0 [95% CI 4.0 - 6.3]、贫血:OR为2.9 [95% CI 2.3 - 3.6]、闭经:OR为2.7 [95% CI 2.3 - 3.2]以及肠易激综合征:OR为2.1 [95% CI 1.9 - 2.4]。诊断前模式与诊断后模式相似。 结论:AN诊断前后诊断模式的相似性表明,许多患者甚至在正式AN诊断前数年就因可能与AN相关的饮食限制、营养不良和体重逐渐减轻有关的状况而接受医学诊断。识别这些早期状况可能有助于更早地诊断AN并改善治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8672/11891635/1f90ee578260/EAT-58-624-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8672/11891635/6056f534b298/EAT-58-624-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8672/11891635/1f90ee578260/EAT-58-624-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8672/11891635/6056f534b298/EAT-58-624-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8672/11891635/1f90ee578260/EAT-58-624-g002.jpg

相似文献

[1]
Patterns of Medical Diagnoses Before and After a Diagnosis of Anorexia Nervosa: A Danish Nationwide Cohort Study.

Int J Eat Disord. 2025-3

[2]
Association of Exposure to Infections in Childhood With Risk of Eating Disorders in Adolescent Girls.

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[3]
Eating Disorders in Children, Adolescents, and Young Adults During and After the COVID-19 Pandemic: A Danish Nationwide Register-Based Study.

Int J Eat Disord. 2024-12

[4]
Overall and cause-specific mortality in anorexia nervosa; impact of psychiatric comorbidity and sex in a 40-year follow-up study.

Int J Eat Disord. 2024-9

[5]
Childhood body mass index and the subsequent risk of anorexia nervosa and bulimia nervosa among women: A large Danish population-based study.

Int J Eat Disord. 2023-8

[6]
Increased risk of somatic diseases following anorexia nervosa in a controlled nationwide cohort study.

Int J Eat Disord. 2022-6

[7]
[The role of a pediatric endocrinologist in diagnostics and therapeutic management of anorexia nervosa--own experiences and review of literature].

Przegl Lek. 2009

[8]
Size at birth and preterm birth in women with lifetime eating disorders: a prospective population-based study.

BJOG. 2015-12-24

[9]
Time trends in lifetime incidence rates of first-time diagnosed anorexia nervosa and bulimia nervosa across 16 years in a Danish nationwide psychiatric registry study.

Int J Eat Disord. 2015-3-23

[10]
Validation of anorexia nervosa and Bulimia nervosa diagnosis coding in Danish hospitals assisted by a natural language processing model.

J Psychiatr Res. 2024-11

本文引用的文献

[1]
Overall and cause-specific mortality in anorexia nervosa; impact of psychiatric comorbidity and sex in a 40-year follow-up study.

Int J Eat Disord. 2024-9

[2]
Prevalence of Rome IV Pediatric Diagnostic Questionnaire-Assessed Disorder of Gut-Brain Interaction, Psychopathological Comorbidities and Consumption of Ultra-Processed Food in Pediatric Anorexia Nervosa.

Nutrients. 2024-3-13

[3]
Outcomes in people with eating disorders: a transdiagnostic and disorder-specific systematic review, meta-analysis and multivariable meta-regression analysis.

World Psychiatry. 2024-2

[4]
Clinical characteristics of hospitalized male adolescents and young adults with atypical anorexia nervosa.

Int J Eat Disord. 2024-4

[5]
Mechanisms and predictors of menses resumption once normal weight is reached in anorexia nervosa.

J Eat Disord. 2023-9-29

[6]
Eating disorders occur at high rates in adolescents with epilepsy and are associated with psychiatric comorbidities and suicidality.

Epilepsia. 2023-11

[7]
Gut-Brain Interaction Disorders and Anorexia Nervosa: Psychopathological Asset, Disgust, and Gastrointestinal Symptoms.

Nutrients. 2023-5-27

[8]
Endocrine complications of anorexia nervosa.

J Eat Disord. 2023-2-15

[9]
Pharmacotherapy in anorexia nervosa: A Danish nation-wide register-based study.

J Psychosom Res. 2023-1

[10]
Pathways to improve early intervention for eating disorders: Findings from a systematic review and meta-analysis.

Int J Eat Disord. 2023-2

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