Clinical features and physiological response to a test meal in purging disorder and bulimia nervosa
Clinical features and physiological response to a test meal in purging disorder and bulimia nervosa
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DOI：
10.1001/archpsyc.64.9.1058
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发表时间：
2007-09-01
影响因子：
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通讯作者：
Jimerson, David C.
中科院分区：
文献类型：
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作者：
Keel, Pamela K.;Wolfe, Barbara E.;Jimerson, David C.
内容：最近的数据表明，净化障碍，最近的特点形式的进食障碍，没有另行说明，可能是值得的疾病分类方案的具体描绘。然而，需要更多的数据来确定如何净化障碍不同贪食症nervosa.Objective：检查临床特征和主观以及客观的生理反应，以标准化的测试餐净化障碍与贪食症nervosa和controls.Design相比：研究访问1包括心理评估结构化的临床访谈和问卷调查。研究访问2包括测试餐反应的评估。设置：从社区招募的参与者在综合临床研究中心完成测试餐研究。参与者：患有DSM-IV神经性贪食症排空亚型（n= 37）和排空障碍（n= 20）的女性和非进食障碍对照（n= 33），体重指数（计算方法为体重（千克）除以身高（米）的平方），年龄在18.5 - 26.5岁之间，未服用精神药物。主要结果测量：进食障碍严重程度的评估，餐后胆囊收缩素反应，以及对试验餐的主观反应。与对照组相比，进食异常在净化障碍和神经性贪食症的参与者中显着升高，但在进食障碍组之间没有差异。与神经性贪食症患者相比，有泻下障碍的患者餐后胆囊收缩素释放量显著增加（t（76.44）= 2.51; P=. 01)与对照组比较差异无统计学意义（t（75.93）= 0.03; P=. 98）。与清除障碍的参与者报告显着更大的餐后饱胀和胃肠道不适与神经性贪食症和controls.Conclusions：清除障碍是一个临床上显着的饮食障碍，似乎是不同的神经性贪食症的主观和生理反应的测试餐。研究结果支持进一步考虑将净化障碍纳入饮食障碍的分类。未来的研究需要对心理生物学的净化障碍，以了解在没有暴饮暴食的情况下，净化的倾向。
Context: Recent data suggest that purging disorder, a recently characterized form of eating disorder not otherwise specified, may be worthy of specific delineation in nosological schemes. However, more data are needed to determine how purging disorder differs from bulimia nervosa.Objective: To examine clinical features and subjective as well as objective physiological responses to a standardized test meal in purging disorder compared with bulimia nervosa and controls.Design: Study visit 1 included psychological assessments with structured clinical interviews and questionnaires. Study visit 2 included assessment of test-meal responses.Setting: Participants recruited from the community completed test-meal studies in a General Clinical Research Center.Participants: Women with DSM-IV bulimia nervosa purging subtype (n= 37) and purging disorder ( n= 20) and non-eating disorder controls ( n= 33) with a body mass index ( calculated as weight in kilograms divided by height in meters squared) between 18.5 and 26.5 who were free of psychotropic medications.Main Outcome Measures: Assessments of eating disorder severity, postprandial cholecystokinin response, and subjective responses to test meals.Results: Eating abnormalities were significantly elevated in participants with purging disorder and bulimia nervosa compared with controls but did not differ between eating disorder groups. Participants with purging disorder demonstrated significantly greater postprandial cholecystokinin release compared with participants with bulimia nervosa (t(76.44)= 2.51; P=. 01) and did not differ significantly from controls (t(75.93)= 0.03; P=. 98). Participants with purging disorder reported significantly greater postprandial fullness and gastrointestinal distress compared with participants with bulimia nervosa and controls.Conclusions: Purging disorder is a clinically significant disorder of eating that appears to be distinct from bulimia nervosa on subjective and physiological responses to a test meal. Findings support further consideration of purging disorder for inclusion in the classification of eating disorders. Future studies on the psychobiology of purging disorder are needed to understand the propensity to purge in the absence of binge eating.