Gillberg I C, Råstam M, Gillberg C
University of Göteborg, Child Neuropsychiatry Clinic, Sweden.
Compr Psychiatry. 1995 Jan-Feb;36(1):61-9. doi: 10.1016/0010-440x(95)90100-a.
Fifty-one adolescent-onset anorexia nervosa (AN) cases recruited after community screening were compared with 51 age-, sex-, and school-matched cases with regard to personality disorders and autism-spectrum disorders (ASD)/empathy disorders at age 21 years. All 102 cases had originally been examined at a mean age of 16 years, slightly over a year after the reported onset of the eating disorder. Structured Clinical Interview for DSM-III-R (SCID) interviews were performed by a psychiatrist blind to the original eating disorder diagnosis. Most of the former AN cases were recovered with respect to weight, but the outcome in social areas was restricted. Personality disorders coded on axis II in the DSM-III-R and empathy disorders were much more common in the AN group than in the comparison (COMP) group. Obsessive-compulsive (OCD) and avoidant personality disorders were particularly common. Obsessive-compulsive behaviors showed a high degree of stability over time and were unrelated to weight problems. Together with empathy disorder, they tended to predict outcome better than the eating disorder as such. It is concluded that in some cases, AN may be seen to reflect but one axis I diagnosis occurring in the life of an individual with a chronic personality disorder.
对社区筛查后招募的51例青少年起病的神经性厌食症（AN）患者与51例年龄、性别和学校匹配的对照者在21岁时的人格障碍及自闭症谱系障碍（ASD）/共情障碍方面进行了比较。所有102例患者最初均在平均年龄16岁时接受检查，这距离所报告的饮食障碍发病略超过一年。由一位对原始饮食障碍诊断不知情的精神科医生进行《精神疾病诊断与统计手册第三版修订本》（DSM-III-R）的结构化临床访谈（SCID）。大多数既往AN患者体重已恢复，但社会领域的结果受限。在DSM-III-R的轴II编码的人格障碍和共情障碍在AN组比在对照组（COMP）中更为常见。强迫型（OCD）和回避型人格障碍尤为常见。强迫行为随时间显示出高度稳定性，且与体重问题无关。与共情障碍一起，它们往往比饮食障碍本身更能预测结果。结论是，在某些情况下，AN可能被视为仅反映在患有慢性人格障碍的个体生活中出现的一种轴I诊断。
