Krüger S, Shugar G, Cooke R G
Westfälisches Zentrum für Psychiatrie, University of Bochum, Germany.
Int J Eat Disord. 1996 Jan;19(1):45-52. doi: 10.1002/(SICI)1098-108X(199601)19:1<45::AID-EAT6>3.0.CO;2-W.
The authors examined the prevalence of binge eating disorder (BED), partial binge eating syndrome, and night binge eating syndrome in subjects with bipolar disorder (BD).
Sixty-one subjects in whom BD was established using DSM-III-R criteria received a semistructured clinical interview including a detailed description of binge eating behavior and of night binge eating. Frequencies were compared to prevalence estimates in community samples.
Eight subjects (13%) met DSM-IV criteria for the diagnosis of BED. An additional 15 subjects (25%) exhibited a partial binge eating syndrome. These two otherwise identical groups of binge eaters were separated only by the DSM-IV frequency criterion. The rates found were higher than rates found in community samples. Ten subjects reported night binge eating in addition to their usual binge eating behavior. This occurred consistently between 2:00 and 4:00 a.m.
Possible underlying mechanisms for the high frequency of binge eating among bipolar subjects are discussed including a model of serotonin-mediated self-modulation of mood. The finding of two groups of binge eaters separated only by the frequency criterion raises questions as to whether the frequency criterion as presently defined in DSM-IV is valid or should be modified.
作者研究了双相情感障碍(BD)患者中暴饮暴食症(BED)、部分暴饮暴食综合征和夜间暴饮暴食综合征的患病率。
61名根据《精神疾病诊断与统计手册》第三版修订版(DSM-III-R)标准确诊为BD的患者接受了半结构化临床访谈,其中包括对暴饮暴食行为和夜间暴饮暴食的详细描述。将频率与社区样本中的患病率估计值进行比较。
8名患者(13%)符合DSM-IV中BED的诊断标准。另外15名患者(25%)表现出部分暴饮暴食综合征。这两组暴饮暴食者除了DSM-IV频率标准外,其他方面完全相同。所发现的患病率高于社区样本中的患病率。10名患者报告除了通常的暴饮暴食行为外,还存在夜间暴饮暴食。这种情况一致发生在凌晨2点至4点之间。
讨论了双相情感障碍患者中暴饮暴食高发的可能潜在机制,包括血清素介导的情绪自我调节模型。仅根据频率标准划分出两组暴饮暴食者这一发现,引发了关于DSM-IV中目前定义的频率标准是否有效或是否应修改的问题。