Fichter M M, Quadflieg N, Gnutzmann A
Department of Psychiatry, University of Munich, Germany.
J Psychosom Res. 1998 Mar-Apr;44(3-4):385-405. doi: 10.1016/s0022-3999(97)00263-8.
Little is known about the long-term course of binge eating disorder (BED). The aim of the study was to assess the 3- and 6-year course and outcome of 68 consecutively treated females with BED. Their mean age was 29.3 years and they were assessed longitudinally at four timepoints: (1) beginning of therapy; (2) end of therapy; (3) 3-year follow-up; and (4) 6-year follow-up. Self rating as well as expert ratings were used for assessment. Symptoms of specific eating disorder as well as general psychopathology were measured. The general pattern of results over time was as follows: substantial improvement during therapy; slight (in most cases nonsignificant) decline during the first 3 years after the end of treatment, and further improvement and stabilization in years 4, 5, and 6 after the end of treatment. At the 6-year follow-up, the majority showed no major DSM-IV eating disorder, 5.9% had BED, 7.4% had shifted to bulimia nervosa (purging type) (DSM-IV), 7.4% were classified as ED-NOS, and one patient died. Based on an operationalized global outcome score for the complete sample, 57.4% had good outcome, 35.3% intermediate outcome, 5.9% poor outcome, and one person (1.4%) died. BED and BNP patients showed very similar intermediate and long-term course in self ratings as well as expert ratings.
关于暴饮暴食症（BED）的长期病程，人们了解甚少。本研究的目的是评估68例连续接受治疗的女性暴饮暴食症患者3年和6年的病程及转归情况。她们的平均年龄为29.3岁，在四个时间点进行纵向评估：（1）治疗开始时；（2）治疗结束时；（3）3年随访；（4）6年随访。采用自评和专家评定进行评估。测量特定饮食失调症状以及一般精神病理学症状。随时间变化的总体结果模式如下：治疗期间有显著改善；治疗结束后的前3年有轻微（大多数情况下无显著意义）下降，治疗结束后的第4、5和6年有进一步改善和稳定。在6年随访时，大多数人未出现主要的DSM-IV饮食失调，5.9%患有暴饮暴食症，7.4%已转变为神经性贪食症（清除型）（DSM-IV），7.4%被归类为未特定的进食障碍（ED-NOS），还有一名患者死亡。根据整个样本的可操作化总体结局评分，57.4%结局良好，35.3%结局中等，5.9%结局不佳，一人（1.4%）死亡。暴饮暴食症患者和神经性贪食症患者在自评和专家评定方面显示出非常相似的中期和长期病程。
