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仍在等待:意大利队列中饮食失调专科治疗的转诊模式、延误及关键因素

Still waiting: referral patterns, delays, and key factors in accessing specialized eating disorder treatment in an Italian cohort.

作者信息

Tempia Valenta Silvia, Marcolini Federica, Scalise Miriam, Verrastro Marco, Rugo Michele, Panariello Fabio, De Ronchi Diana, Atti Anna Rita

机构信息

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Doctoral Program of Global Health, Humanitarian Aid and Disaster Medicine, Vrije Universiteit Brussel, Brussels, Belgium.

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

出版信息

Eat Behav. 2025 Apr;57:101968. doi: 10.1016/j.eatbeh.2025.101968. Epub 2025 Mar 17.

Abstract

BACKGROUND

Eating disorders (EDs) are prevalent psychopathological conditions with significant psycho-physical consequences. Despite advances in diagnostic tools and treatment approaches, many patients experience barriers to accessing specialized ED care (SEDC). This study aimed to (1) examine the timeline of the care pathway from symptom onset to referral to a regional SEDC; (2) assess the association between referral to SEDC and factors such as the initial healthcare provider and clinical symptoms; and (3) investigate the relationship between the care pathway and clinical severity at the time of referral.

METHODS

This study analyzed data from 174 patients accessing the SEDC in Bologna, Italy, between 2022 and 2024. Chi-square tests and Kendall Tau correlations were used to assess the associations between referral patterns, healthcare professionals, symptom severity, and healthcare contacts prior to referral.

RESULTS

On average, participants took 26.3 months from symptom onset to seek help and 53.7 months before reaching the SEDC. General practitioners and psychiatric services had higher referral rates to SEDC. Weight loss and amenorrhea were positively associated with referrals, while depressed mood and fear of weight gain showed negative associations. No significant link was found between the care pathway and clinical severity at the time of referral.

CONCLUSION

Referral to SEDC is associated with the type of healthcare provider initially consulted and the presence of specific symptoms, particularly weight loss and amenorrhea. These findings highlight the importance of enhancing awareness among frontline healthcare providers to promote earlier recognition and referral of ED cases.

摘要

背景

饮食失调(EDs)是普遍存在的精神病理状况,会产生重大的身心后果。尽管诊断工具和治疗方法有所进步,但许多患者在获得专门的饮食失调护理(SEDC)方面仍面临障碍。本研究旨在:(1)检查从症状出现到转诊至地区性SEDC的护理路径的时间线;(2)评估转诊至SEDC与诸如最初的医疗保健提供者和临床症状等因素之间的关联;(3)调查护理路径与转诊时临床严重程度之间的关系。

方法

本研究分析了2022年至2024年期间在意大利博洛尼亚接受SEDC治疗的174名患者的数据。采用卡方检验和肯德尔 Tau 相关性分析来评估转诊模式、医疗保健专业人员、症状严重程度和转诊前的医疗接触之间的关联。

结果

平均而言,参与者从症状出现到寻求帮助花费了26.3个月,而到达SEDC则花费了53.7个月。全科医生和精神科服务机构对SEDC的转诊率较高。体重减轻和闭经与转诊呈正相关,而情绪低落和对体重增加的恐惧呈负相关。在转诊时,护理路径与临床严重程度之间未发现显著关联。

结论

转诊至SEDC与最初咨询的医疗保健提供者类型以及特定症状的存在有关,特别是体重减轻和闭经。这些发现凸显了提高一线医疗保健提供者的意识以促进对饮食失调病例的早期识别和转诊的重要性。

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