Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa
Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa
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DOI：
10.1186/1751-0759-2-5
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发表时间：
2008-01-01
影响因子：
2.1
通讯作者：
Ishikawa, Toshio
中科院分区：
文献类型：
--
作者：
Nishimura, Hiroki;Komaki, Gen;Ishikawa, Toshio
背景：神经性厌食症(AN-R)患者有时会出现伴随的暴食症症状或完全的神经性暴食症(BN)综合征。如果临床医生能够预测谁可能转变为暴食症亚型或BN，就可以采取预防措施。因此，我们调查了可能与这种变化相关的人体测量和心理因素。方法：所有参与者都来自日本饮食障碍遗传研究小组的一项研究。在80例最初诊断为AN-R的患者中，22例在一段时间内转变为AN-BP，14例转变为BN。其余44例患者仅在发病至调查期间保持An-R。方差分析比较的变量包括人体测量，人格特质，如多重完美主义量表得分和气质和性格问卷得分，以及Beck抑郁问卷-II得分。结果：与单纯BN患者相比，患有BN的患者当前BMI(p<；0.05)和既往最大BMI(p<；0.05)均显著升高。他们在父母批评这一心理特征上得分明显更高(p<；0.05)，在自我导向方面得分更低(p<；0.05)，这证实了之前的报道，但当抑郁得分作为协变量时，这些差异就消失了。不同病程的An-R患者在人格特征或抑郁方面无显著差异。结论：本研究结果提示An-R向BN过渡的患者有肥胖倾向。低自主性和父母的高度批评可能与AN-R患者发生BN有关，尽管这种差异也可能与抑郁有关。
Background: Patients with anorexia nervosa-restricting type (AN-R) sometimes develop accompanying bulimic symptoms or the full syndrome of bulimia nervosa (BN). If clinicians could predict who might change into the bulimic sub-type or BN, preventative steps could be taken. Therefore, we investigated anthropometric and psychological factors possibly associated with such changes.Method: All participants were from a study by the Japanese Genetic Research Group for Eating Disorders. Of 80 patients initially diagnosed with AN-R, 22 changed to the AN-Binge Eating/Purging Type (AN-BP) and 14 to BN for some period of time. The remaining 44 patients remained AN-R only from the onset to the investigation period. Variables compared by ANOVA included anthropometric measures, personality traits such as Multiple Perfectionism Scale scores and Temperament and Character Inventory scores, and Beck Depression Inventory-II scores.Results: In comparison with AN-R only patients, those who developed BN had significantly higher current BMI (p < 0.05) and maximum BMI in the past (p < 0.05). They also scored significantly higher for the psychological characteristic of parental criticism (p < 0.05) and lower in self-directedness (p < 0.05), which confirms previous reports, but these differences disappeared when the depression score was used as a co-variant. No significant differences were obtained for personality traits or depression among the AN-R only patients irrespective of their duration of illness.Conclusion: The present findings suggest a tendency toward obesity among patients who cross over from AN-R to BN. Low self-directedness and high parental criticism may be associated with the development of BN by patients with AN-R, although the differences may also be associated with depression.