Herzog D B, Sacks N R, Keller M B, Lavori P W, von Ranson K B, Gray H M
Harvard Medical School.
J Am Acad Child Adolesc Psychiatry. 1993 Jul;32(4):835-42. doi: 10.1097/00004583-199307000-00020.
The purpose of this study was to assess the course and outcome of anorexia nervosa and bulimia nervosa at 1 year in a large cohort of women with eating disorders.
A prospective, naturalistic, longitudinal design was used to map the course of 225 women with anorexia nervosa, bulimia nervosa, and mixed anorexia and bulimia nervosa. Structured interviews were conducted quarterly. Follow-up data are presented in terms of patterns of recovery, clinical features predictive of time to recovery, and the role of comorbid disorders as fixed predictors.
The recovery rate of bulimics was significantly better than that of anorexic or mixed subjects, yet nearly half the anorexic and mixed subjects no longer met full DSM-III-R criteria for at least 8 consecutive weeks during the first year of follow-up. Percent ideal body weight and type of eating disorder were significantly associated with outcome.
Our findings suggest that the diagnosis of anorexia nervosa has severe implications.
本研究旨在评估一大批饮食失调女性中神经性厌食症和神经性贪食症在1年时的病程及转归。
采用前瞻性、自然主义的纵向设计来描绘225例患有神经性厌食症、神经性贪食症以及神经性厌食症与神经性贪食症混合型的女性的病程。每季度进行结构化访谈。随访数据按照康复模式、预测康复时间的临床特征以及共病作为固定预测因素的作用进行呈现。
贪食症患者的康复率显著高于厌食症或混合型患者，但在随访的第一年中，近一半的厌食症和混合型患者至少连续8周不再完全符合DSM-III-R标准。理想体重百分比和饮食失调类型与转归显著相关。
我们的研究结果表明神经性厌食症的诊断具有严重影响。
