Walters E E, Kendler K S
Department of Psychiatry, Medical College of Virginia/Virginia Commonwealth University, Richmond.
Am J Psychiatry. 1995 Jan;152(1):64-71. doi: 10.1176/ajp.152.1.64.
The authors explored the epidemiologic characteristics and risk factors of anorexia nervosa and examined the relationship between narrowly defined anorexia nervosa and anorexia-like syndromes.
Structured interviews were administered to a population-based sample of 2,163 female twins. Anorexia nervosa was diagnosed by computer algorithm ("computer narrow") and by narrow and broad clinical definitions.
Lifetime prevalence estimates of 0.51%, 1.62%, and 3.70% were obtained for the computer narrow, clinical narrow, and clinical broad diagnoses, respectively. Dieting status, greater number of years of parental education, low self-esteem, high levels of neuroticism, and maternal overprotectiveness were significantly associated with anorexia nervosa. Both the pattern of comorbidity and the relationship to epidemiologic risk factors suggested an etiologic continuity between narrowly and broadly defined anorexic syndromes. Co-twins of twins with anorexia nervosa were at significantly higher risk for lifetime anorexia nervosa, bulimia nervosa, major depression, and current low body mass index. Significant comorbidity was found between anorexia nervosa and major depression, bulimia nervosa, generalized anxiety disorder, alcoholism, phobias, and panic disorder.
The authors' analyses support the hypothesis of a spectrum of anorexic-like syndromes in women. These syndromes are familial and share familial etiologic factors with major depression and bulimia nervosa.
作者探讨神经性厌食症的流行病学特征和危险因素，并研究狭义神经性厌食症与类厌食综合征之间的关系。
对基于人群的2163名女性双胞胎样本进行结构化访谈。通过计算机算法（“计算机狭义诊断”）以及狭义和广义临床定义对神经性厌食症进行诊断。
计算机狭义诊断、临床狭义诊断和临床广义诊断的终生患病率估计分别为0.51%、1.62%和3.70%。节食状态、父母受教育年限增加、自卑、高神经质水平和母亲过度保护与神经性厌食症显著相关。共病模式以及与流行病学危险因素的关系均表明狭义和广义定义的厌食综合征之间存在病因连续性。神经性厌食症双胞胎的同卵双胞胎患终生神经性厌食症、神经性贪食症、重度抑郁症和当前低体重指数的风险显著更高。神经性厌食症与重度抑郁症、神经性贪食症、广泛性焦虑症、酒精中毒、恐惧症和惊恐障碍之间存在显著共病。
作者的分析支持女性中存在一系列类厌食综合征的假设。这些综合征具有家族性，并且与重度抑郁症和神经性贪食症共享家族病因因素。
