Bozzola Elena, Cirillo Flavia, Mascolo Cristina, Antilici Livia, Raucci Umberto, Guarnieri Benedetta, Ventricelli Annamaria, De Santis Elettra, Spina Giulia, Raponi Massimiliano, Villani Alberto, Marchili Maria Rosaria
Pediatric Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Pediatric Emergency Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Nutrients. 2024 Dec 25;17(1):21. doi: 10.3390/nu17010021.
Anorexia nervosa is a serious eating disorder that mainly affects children and adolescents. Most patients present with extreme body dissatisfaction and an obsessive focus on body weight and food. Anorexia nervosa is a complex and multifactorial condition characterised by biological, psychological, and social factors. However, studies that have explored the cumulative risk that predisposes to anorexia nervosa are limited. This study aims to explore the potential risk factors for a severe form of the disease in patients affected by anorexia nervosa and to identify whether they may interact and reinforce each other, contributing to the severity of the disorder.
For this study, we enrolled children and adolescents under 18 years of age hospitalised at IRCCS Bambino Gesù Pediatric Hospital, Rome, Italy, for anorexia nervosa from 1 December 2022 to 31 August 2024, identifying and analysing potential risk factors. Elevated shape and weight concerns were found in all patients. Psychiatric and neurodevelopment comorbidities were identified in 76 patients (51.35%), life stress events in 69 (46.62%), and a family history of eating and weight control behaviours in 39 (26.35%). Out of the sample size, 20.27% of patients did not live in a traditionally structured family. This study used the Kiddie-SADS-Present and Lifetime Version interview, the Coddington Life Events Scales, and the Trauma Symptom Checklist for Children questionnaires.
Patients with an extreme or severe index of anorexia nervosa are more likely to have multiple predisposing factors. In detail, four predisposing factors were found in 18.6% of patients with an extreme severity index, in 15.5% of those with a severe score, and in 10.3 and 10.6% of those with a moderate and mild score, respectively.
Cumulative potential risk factors are more likely to be found in cases of severe course disease and patients hospitalised for anorexia. Prompt identification of predisposing factors and an effective plan of action are required to avoid a severe course disorder.
神经性厌食症是一种严重的饮食失调症，主要影响儿童和青少年。大多数患者表现出对身体的极度不满以及对体重和食物的过度关注。神经性厌食症是一种复杂的多因素疾病，其特征涉及生物学、心理学和社会因素。然而，探索易患神经性厌食症的累积风险的研究有限。本研究旨在探讨神经性厌食症患者中该疾病严重形式的潜在风险因素，并确定它们是否可能相互作用和强化，从而导致病情严重程度增加。
在本研究中，我们纳入了2022年12月1日至2024年8月31日期间在意大利罗马的IRCCS Bambino Gesù儿童医院因神经性厌食症住院的18岁以下儿童和青少年，识别并分析潜在风险因素。在所有患者中均发现对体型和体重的关注度升高。76名患者（51.35%）存在精神和神经发育共病，69名（46.62%）有生活应激事件，39名（26.35%）有饮食和体重控制行为的家族史。在样本中，20.27%的患者并非生活在传统结构的家庭中。本研究使用了儿童情感障碍及精神分裂症问卷（适用于当前和一生版本）、科丁顿生活事件量表以及儿童创伤症状检查表问卷。
患有极端或严重神经性厌食症指数的患者更有可能存在多种诱发因素。具体而言，在极端严重程度指数的患者中，18.6%发现有四种诱发因素；严重评分的患者中这一比例为15.5%；中度和轻度评分的患者中分别为10.3%和10.6%。
在病情严重的病例以及因神经性厌食症住院的患者中，更有可能发现累积的潜在风险因素。需要及时识别诱发因素并制定有效的行动计划，以避免病情发展为严重疾病。
