Early Course of Symptom Development in Anorexia Nervosa.
Early Course of Symptom Development in Anorexia Nervosa.
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DOI：
10.1016/j.jadohealth.2022.06.010
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发表时间：
2022-11
影响因子：
7.6
通讯作者：
Steinglass, Joanna E.
中科院分区：
文献类型：
--
作者：
Ranzenhofer, Lisa M.;Jablonski, Monica;Davis, Lauren;Posner, Jonathan;Walsh, B. Timothy;Steinglass, Joanna E.
神经性厌食症（AN）通常开始于青春期，然而，症状轨迹的详细知识，包括其时间顺序，是不太清楚。本研究的目的是描述的发病和持续时间的饮食行为紊乱之前，诊断为AN，检查儿童和父母的报告之间的一致性，并检查症状发作的时间和疾病严重程度之间的关系。对71名青少年（年龄12-18岁）及其父母进行了有关节食、限制、失控/暴饮暴食、腹泻、过度/强迫性运动、体重史和闭经的采访。计算身体质量指数，青少年完成饮食失调检查问卷。大多数样本报告了限制，体重不足，节食和过度运动;不到三分之一的人报告了腹泻，饮食失控和超重。节食通常首先出现，平均在14岁左右;其余的行为往往出现在14岁到14岁半之间;正式诊断的平均年龄略高于15岁。除了节食，二人组在所有行为的存在和时间方面都有很好的一致性，与父母相比，儿童报告的节食行为的发作时间早6个月/持续时间更长。虽然年龄较大的采访与较低的体重指数百分位数和较高的EDE-Q评分，无论是发病年龄或持续时间与严重程度时，控制当前的年龄。青少年和父母描述了一系列类似的行为变化，导致AN的诊断，通常从节食开始，发生在大约1到1年半的时间内。询问青少年和父母饮食行为的变化可能有助于识别和早期干预AN;体重正常的青少年持续节食或限制性饮食可能需要更频繁的体重监测。
Anorexia nervosa (AN) commonly begins in adolescence; however, detailed knowledge of symptom trajectories, including their temporal sequence, is less well elucidated. The purpose of the present study is to describe the onset and duration of disordered eating behaviors prior to a diagnosis of AN, examine concordance between child and parent report, and examine the relationships between timing of symptom onset and illness severity. Seventy-one adolescents (ages 12–18 years) and their parents were interviewed about dieting, restriction, loss of control/binge eating, purging, excessive/compulsive exercise, weight history, and amenorrhea. Body mass index percentiles were calculated, and adolescents completed the Eating Disorder Examination-Questionnaire. Restriction, being underweight, dieting, and excessive exercise were reported by most of the sample; purging, loss-of-control eating, and having been overweight were reported by less than a third. Dieting typically emerged first, on average around age 14; the remainder of behaviors tended to emerge between ages 14 and 14½; and average age of formal diagnosis was slightly over 15 years. Dyads had good agreement regarding presence and timing of all behaviors except for dieting, for which children reported about 6 months earlier onset/longer duration, compared to parents. Although older age at interview was associated with lower body mass index percentile and higher EDE-Q score, neither age of onset nor duration was associated with severity when controlling for current age. Teens and parents describe a similar sequence of behavior changes leading up to a diagnosis of AN that typically begins with dieting and occurs over an approximate 1- to 1½-year period. Querying teens and parents about eating behavior changes may aid in identification and early intervention in AN; adolescents with normal weight who engage in persistent dieting or restrictive eating may warrant more frequent weight monitoring.
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