Prospective 10-year follow-up in adolescent anorexia nervosa -: Course, outcome, psychiatric comorbidity, and psychosocial adaptation
Prospective 10-year follow-up in adolescent anorexia nervosa -: Course, outcome, psychiatric comorbidity, and psychosocial adaptation
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DOI：
10.1111/1469-7610.00756
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发表时间：
2001-07-01
影响因子：
7.6
通讯作者：
Remschmidt, H
中科院分区：
文献类型：
--
作者：
Herpertz-Dahlmann, B;Müller, B;Remschmidt, H
本研究的目的是通过重复评估来追踪青少年神经性厌食症的长期病程。分析饮食失调病程与精神共病之间的关联。并评估心理社会结果。样本由 39 名住院患者组成，他们在出院后 3 年、7 年和 10 年进行了重新调查。患者和 39 名对照者的年龄、性别相匹配。通过对 DSM-III-R 饮食失调、附加轴 I 和轴 II 精神障碍以及心理社会功能的结构化访谈来评估职业状态。结果显示，69% 的原始受试者在 10 年随访中符合完全康复的标准。一名患者（3%）仍表现出限制性神经性厌食症的全面综合征，两名患者（5%）仍表现出神经性贪食症的全面综合征。没有患者死亡。在受试者中，51% 目前患有 I 轴精神障碍，23% 符合人格障碍的全部标准。除了饮食失调之外。焦虑症以及回避依赖性和强迫性人格障碍是最常见的精神疾病诊断。精神共病与饮食失调的结果之间以及结果与心理社会适应之间存在显着关联。在精神发病率和心理社会功能方面，长期康复的患者与正常对照者没有显着差异。结论是，在大多数患者中，青少年神经性厌食症的病程较长，尽管它似乎比成人发病的形式更有利。那些从饮食失调中完全康复的人很有可能克服其他精神疾病并适应社会要求。
The aim of the present study was to follow up the long-term course of adolescent-onset anorexia nervosa by repeated assessment. to analyze the association between the course of the eating disorder and psychiatric comorbidity. and to evaluate psychosocial outcome. The sample consisted of 39 inpatients who were reinvestigated 3. 7, and 10 years after discharge. The patients and 39 controls matched for age, gender. and occupational status were assessed with structured interviews on DSM-III-R eating disorders, additional axis I and axis II psychiatric disorders, and psychosocial functioning. Results showed that 69 % of the original subjects met the criteria for full recovery at the 10-year follow-up. One patient (3 %) still exhibited the full syndrome of restrictive anorexia nervosa, two patients (5 %) the full syndrome of bulimia nervosa. None of the patients had died. Of the subjects, 51 % currently had an axis I psychiatric disorder and 23 % met the full criteria for a personality disorder. Apart from the eating disorder. anxiety disorders and avoidant-dependent and obsessive-compulsive personality disorders were the most common psychiatric diagnoses. There was a significant association between psychiatric comorbidity and the outcome of the eating disorder and between outcome and psychosocial adaptation. With regard to psychiatric morbidity and psychosocial functioning, long-term recovered patients did not differ significantly from normal controls. It is concluded that in most patients adolescent anorexia nervosa takes a prolonged course, although it seems to be more favorable than in adult-onset forms. Those who achieve complete recovery from the eating disorder have a good chance of overcoming other psychiatric disorders and to adapt to social requirements.