Depression and eating disorders.
Depression and eating disorders.
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DOI：
10.1002/(sici)1520-6394(1998)8:1
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发表时间：
1998-01-01
影响因子：
7.4
通讯作者：
Casper, R C
中科院分区：
文献类型：
--
作者：
Casper, R C
抑郁症和进食障碍都是多维异质性障碍。本文通过回顾与此问题相关的临床描述性、家族遗传学、治疗和生物学研究来探讨它们之间关系的性质。这些研究证实了抑郁症状和抑郁症在饮食失调中的突出性。其他发生频率较低的精神综合征，如神经性厌食症中的焦虑症和强迫症，或神经性贪食症中的人格障碍、焦虑症和物质滥用，也在饮食障碍的发展和维持中起重要作用。由于很少有研究控制饥饿引起的身体，内分泌或心理变化，这些变化模拟了被认为是抑郁症诊断的症状，因此需要进一步的研究。共同病因的证据对于神经性厌食症并不令人信服，最多提示神经性贪食症。由于在当代情况下，饮食引起的体重减轻是主要的诱因，具有自我批评或抑郁特征的女性将不成比例地被招募到饮食失调中。最适合数据的模型将适应饮食障碍和从无抑郁到重度抑郁的全谱抑郁障碍之间的关系，贪食性厌食症和神经性贪食症患者的抑郁率略高于限制性神经性厌食症患者，但该模型将承认每种饮食障碍的特定病理生理学和精神病理学。
Both depressive disorders and eating disorders are multidimensional and heterogeneous disorders. This paper examines the nature of their relationship by reviewing clinical descriptive, family-genetic, treatment, and biological studies that relate to the issue. The studies confirm the prominence of depressive symptoms and depressive disorders in eating disorders. Other psychiatric syndromes which occur with less frequency, such as anxiety disorders and obsessive-compulsive disorders in anorexia nervosa, or personality disorders, anxiety disorders, and substance abuse in bulimia nervosa, also play an important role in the development and maintenance of eating disorders. Since few studies have controlled for starvation-induced physical, endocrine, or psychological changes which mimic the symptoms considered diagnostic for depression, further research will be needed. The evidence for a shared etiology is not compelling for anorexia nervosa and is at most suggestive for bulimia nervosa. Since in contemporary cases dieting-induced weight loss is the principal trigger, women with self-critical or depressive features will be disproportionately recruited into eating disorders. The model that fits the data best would accommodate a relationship between eating disorders and the full spectrum of depressive disorders from no depression to severe depression, with somewhat higher rates of depression in bulimic anorectic and bulimia nervosa patients than in restricting anorexia nervosa patients, but the model would admit a specific pathophysiology and psychopathology in each eating disorder.