Health problems, impairment and illnesses associated with bulimia nervosa and binge eating disorder among primary care and obstetric gynaecology patients
Health problems, impairment and illnesses associated with bulimia nervosa and binge eating disorder among primary care and obstetric gynaecology patients
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DOI：
10.1017/s0033291701004640
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发表时间：
2001-11-01
影响因子：
6.9
通讯作者：
Williams, JBW
中科院分区：
文献类型：
--
作者：
Johnson, JG;Spitzer, RL;Williams, JBW
背景资料。虽然众所周知，患有进食障碍的精神病患者存在各种健康问题的风险，但对其他人群中的进食障碍及其相关健康问题知之甚少。采用流行病学调查的方法，对妇产科女性患者的神经性暴食症(BN)和暴饮暴食障碍(BED)相关的健康问题和损害进行调查。对全美8家初级保健诊所和7家妇产科诊所的4651名女性患者(年龄在18岁到99岁之间)进行了精神障碍、躯体疾病、残疾、功能状态和压力的评估。289名妇女(6(.)2%)被诊断为BN或BED。在年轻和中年妇女中，BN的患病率约为1%。从成年期早期(3(.)3%)到中年(8.5%)，床的患病率稳步上升。焦虑症、情绪障碍和糖尿病在患有BN或BED的女性中比在没有这些饮食障碍的女性中更常见。在对共生精神障碍进行统计控制后，患有BN或BED的女性报告称，与没有BN或BED的女性相比，她们的功能明显较差，残疾、健康问题、失眠、心理社会压力和自杀念头的水平要高得多。然而，只有不到十分之一的BN或BED被患者的医生识别。患有BN或BED的患者通常会经历相当大的残疾、损害、痛苦和共生疾病。提高对饮食失调的认识可能是鼓励更多患者寻求治疗这些致残疾病的关键一步。
Background. Although psychiatric patients with eating disorders are known to be at risk for a variety of health problems, relatively little is known about eating disorders and associated health problems in other populations. An epidemiological study was conducted to investigate health problems and impairment associated with bulimia nervosa (BN) and binge eating disorder (BED) among female primary care and obstetric gynaecology patients.Methods. Psychiatric disorders, physical illnesses, disabilities, functional status and stress were assessed among 4651 female patients (age range:18 to 99 years) at 8 primary care and 7 obstetric gynaecology clinics throughout the United States.Results. Two hundred eighty-nine women (6(.)2 %) were diagnosed with BN or BED. The prevalence of BN was approximately 1 % among young and middle-aged women. The prevalence of BED increased steadily from early (3(.)3 %) through middle (8(.)5 %) adulthood. Anxiety disorders, mood disorders and diabetes were much more common among women with BN or BED than among women without these eating disorders. Women with BN or BED reported markedly poorer functioning and much higher levels of disability, health problems, insomnia, psychosocial stress and suicidal thoughts than did women without BN or BED, after co-occurring psychiatric disorders were controlled statistically. Yet, fewer than one of ten cases of BN or BED was recognized by the patients' physicians.Conclusions. Patients with BN or BED often experience considerable disability, impairment, distress and co-occurring illnesses. Increased recognition of eating disorders may be a crucial step towards encouraging more patients to seek treatment for these disabling conditions.