Bushnell J A, Wells J E, McKenzie J M, Hornblow A R, Oakley-Browne M A, Joyce P R
Department of Psychological Medicine, Wellington School of Medicine, University of Otago, New Zealand.
Psychol Med. 1994 Aug;24(3):605-11. doi: 10.1017/s0033291700027756.
This study compares rates of comorbidity of lifetime psychiatric disorder in a clinical sample of women with bulimia, with general population base rates, and with rates of comorbidity among bulimic women in the general population. Eighty-four per cent of the clinical sample of bulimic women had a lifetime affective disorder, and 44% a lifetime alcohol or drug disorder. These rates of disorder were significantly higher than the base rates in the general population. Bulimic women in the general population also had more affective and substance-use disorders than the general population base rates, but the rates of these disorders were lower than found in the clinical sample. In the general population, quite similar rates of other disorders including generalized anxiety, panic, phobia and obsessive-compulsive disorder, are found among those with bulimia, substance-use disorder and depression. Furthermore, among those with depression and substance-use disorder in the general population, rates of eating disorder are comparable. Rather than suggesting a specific relationship between bulimia and either depression or substance-use disorder, the data from this study suggest that the presence of any disorder is associated with a non-specific increase in the likelihood of other psychiatric disorder.
本研究比较了神经性贪食症女性临床样本中终身精神障碍的共病率、一般人群的基础发病率以及普通人群中神经性贪食症女性的共病率。神经性贪食症女性临床样本中，84%患有终身情感障碍，44%患有终身酒精或药物障碍。这些障碍的发生率显著高于一般人群的基础发病率。普通人群中的神经性贪食症女性也比一般人群基础发病率有更多的情感和物质使用障碍，但这些障碍的发生率低于临床样本中的发生率。在普通人群中，神经性贪食症患者、物质使用障碍患者和抑郁症患者中其他障碍（包括广泛性焦虑、惊恐、恐惧症和强迫症）的发生率相当相似。此外，在普通人群中患有抑郁症和物质使用障碍的人群中，饮食障碍的发生率相当。本研究的数据并非表明神经性贪食症与抑郁症或物质使用障碍之间存在特定关系，而是表明任何一种障碍的存在都与其他精神障碍发生可能性的非特异性增加有关。
