Longitudinal relationships between childhood, adolescent, and adult eating disorders
Longitudinal relationships between childhood, adolescent, and adult eating disorders
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DOI：
10.1097/00004583-200112000-00014
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发表时间：
2001-12-01
影响因子：
13.3
通讯作者：
Walsh, BT
中科院分区：
文献类型：
--
作者：
Kotler, LA;Cohen, P;Walsh, BT
目的：探讨儿童期至成年期饮食问题的纵向病程。以下问题得到了回答：(1)从童年到成年的17年间，饮食失调的症状和诊断有多稳定？(2)幼儿饮食问题是否预示成年期饮食失调的发生？方法：从流行病学上选择了大约800名儿童及其母亲，分别于1975年、1983年、1985年和1992年接受了基于dsm的结构化精神病学评估。对神经性厌食症和神经性贪食症的完整DSM诊断标准、DSM标准衍生的症状量表以及青春期早期、青春期晚期和青年期的暴饮暴食或节食等个体症状的稳定性进行了检查。结果：青少年早期神经性贪食与青少年晚期神经性贪食的风险增加9倍有关，与成年神经性贪食的风险增加20倍有关。青少年晚期的神经性贪食症与成人神经性贪食症的风险增加35倍有关。神经性厌食症和神经性贪食症的症状量表得分在青春期早期到晚期和成年早期的0.3到0.5范围内相关。对于神经性厌食症和神经性贪食症，性别，以及青春期早期和晚期的饮食症状，都预示着年轻人的饮食失调症状。饮食失调后期发展的风险因素包括饮食冲突、与食物斗争以及儿童早期不愉快的饮食。结论：儿童早期的饮食问题或青春期的饮食失调会给成年后的饮食失调带来很大的风险。
Objective: This study investigates the longitudinal course of eating problems from childhood though adulthood. The following questions are answered: (1) How stable are eating disorder symptoms and diagnoses over a 17-year interval from childhood to adulthood? (2) Do early childhood eating problems predict the occurrence of eating disorders in adulthood? Method: An epidemiologically selected sample of approximately 800 children and their mothers received DSM-based structured psychiatric assessments in 1975, 1983, 1985, and 1992. The stability of full DSM diagnostic criteria for anorexia nervosa and bulimia nervosa, symptom scales derived from DSM criteria, and individual symptoms such as binge eating or dieting between early adolescence, late adolescence, and young adulthood was examined. Results: Early adolescent bulimia nervosa is associated with a 9-fold increase in risk for late adolescent bulimia nervosa and a 20-fold increase in risk for adult bulimia nervosa. Late adolescent bulimia nervosa is associated with a 35-fold increase in risk for adult bulimia nervosa. Symptom scale scores for anorexia nervosa and bulimia nervosa correlate in the 0.3 to 0.5 range from early to late adolescence and young adulthood. For both anorexia nervosa and bulimia nervosa, gender, as well as eating symptoms at early and late adolescence, all predict young-adult eating disorder symptoms. Risk factors for the later development of eating disorders comprise eating conflicts, struggles with food, and unpleasant meals in early childhood. Conclusion: The presence of eating problems in early childhood or an eating disorder in adolescence confers a strong risk for an eating disorder in young adulthood.