Halmi K A
Psychiatr Clin North Am. 1982 Aug;5(2):371-7.
Anorexia nervosa and bulimia are the prevalent eating disorders in adolescence and can well be regarded as a public health problem. Information on weight history, menstrual history, eating behavior, purging behavior, preoccupation with and fear of weight gain, activity level, depressive symptomatology, and impulsive behaviors is necessary in order to make the diagnosis of anorexia nervosa or bulimia. It is important to remember that bulimia patients have a fluctuation of weight within a normal weight range and usually do not have amenorrhea. The treatment of anorexia nervosa must include medical management, psychotherapy, behavioral therapy, and family therapy. Beginning treatment with outpatient therapy may be successful in adolescents who have a good prognosis and whose parents are willing to cooperate in family therapy. If a patient remains underweight, then she is not being effectively treated for the anorexia nervosa. Most patients will need an initial hospitalization for nutritional rehabilitation and continued outpatient therapy. Recently, bulimia has been recognized as a discrete disorder. Treatment approaches are currently being developed for this disorder and include behavioral techniques, group therapy, antidepressant and anticonvulsant medication, and psychotherapy.
神经性厌食症和贪食症是青少年中普遍存在的饮食失调症，完全可被视为一个公共卫生问题。为了诊断神经性厌食症或贪食症，有必要了解体重史、月经史、饮食行为、清除行为、对体重增加的过度关注和恐惧、活动水平、抑郁症状以及冲动行为等信息。重要的是要记住，贪食症患者的体重在正常体重范围内波动，通常不会闭经。神经性厌食症的治疗必须包括药物治疗、心理治疗、行为治疗和家庭治疗。对于预后良好且其父母愿意配合家庭治疗的青少年，开始采用门诊治疗可能会取得成功。如果患者体重持续偏低，那么她的神经性厌食症就没有得到有效治疗。大多数患者最初需要住院进行营养康复，并持续接受门诊治疗。最近，贪食症已被确认为一种独立的疾病。目前正在为这种疾病开发治疗方法，包括行为技术、团体治疗、抗抑郁药和抗惊厥药以及心理治疗。
