Impact of pregnancy on bulimia nervosa
Impact of pregnancy on bulimia nervosa
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DOI：
10.1192/bjp.174.2.135
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发表时间：
1999-02-01
影响因子：
10.5
通讯作者：
Sedgwick, PM
中科院分区：
文献类型：
--
作者：
Morgan, JF;Lacey, JH;Sedgwick, PM
研究背景神经性贪食症（Bulimia nervosa）影响处于生殖功能高峰期的女性，但很少有研究探讨妊娠对贪食症的影响。目的探讨妊娠对神经性贪食症症状及相关精神病理学的影响。方法采用进食障碍检查法对94例妊娠期神经性贪食症患者进行访谈（第12版）和DSM-III-R的结构化临床访谈，以及额外的结构化问题。行为记录在概念，每三个月和出生后。相对危险度计算预后factors.Results暴食症状改善整个怀孕。分娩后，57%的人的症状比怀孕前更严重，但34%的人不再有暴食症。复发的预测行为的严重程度和持久性，以前的神经性厌食症（“II型”贪食症），妊娠糖尿病和“计划外”怀孕。计划外怀孕是正常现象，通常是由于对生育的错误信念。"产后抑郁症"建议在三分之一的样本，并在三分之二的"II型"贪食症，并预测酒精滥用，症状的严重程度和persistence.Conclusions产后治疗干预应侧重于妇女的"风险"的复发，但所有妇女与贪食症应评估产后抑郁症。
Background Bulimia nervosa affects women at a peak age of reproductive functioning, but few studies have examined the impact of pregnancy on bulimia.Aim To examine the impact of pregnancy on symptoms of bulimia nervosa and associated psychopathologyMethod Women actively suffering from bulimia nervosa during pregnancy (n=94) were interviewed using the eating disorder examination (12th edn) and structured clinical interview for DSM-III-R, with additional structured questions. Behaviours were recorded at conception, each trimester and postnatally. Relative risks were calculated for prognostic factors.Results Bulimic symptoms improved throughout pregnancy. After delivery, 57% had worse symptoms than pre-pregnancy, but 34% were no longer bulimic. Relapse was predicted by behavioural severity and persistence, previous anorexia nervosa ('Type II' bulimia), gestational diabetes and 'unplanned' pregnancy. Unplanned pregnancies were the norm, usually resulting from mistaken beliefs about fertility. 'Postnatal depression' was suggested in one-third of the sample, and in two-thirds of those with 'Type II' bulimia, and was predicted by alcohol misuse, symptom severity and persistence.Conclusions Postnataltreatment intervention should focus on women 'at risk' of relapse, but all women with bulimia should be assessed for postnatal depression.Declaration of interest None.