Prospective Association of Common Eating Disorders and Adverse Outcomes
Prospective Association of Common Eating Disorders and Adverse Outcomes
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DOI：
10.1542/peds.2011-3663
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发表时间：
2012-08-01
期刊：
影响因子：
8
通讯作者：
Horton, Nicholas J.
中科院分区：
文献类型：
--
作者：
Field, Alison E.;Sonneville, Kendrin R.;Horton, Nicholas J.
目的：神经性厌食症和神经性贪食症（BN）很少见，但非特异性饮食失调（EDNOS）在女性参与者中相对常见。我们的目的是评估BN和EDNOS亚型是否能预测不良结局。方法：本研究包括对正在进行的成长研究中的8594名女性参与者的前瞻性分析。调查问卷从1996年到2001年每年发送一次，然后在2007年和2008年每两年发送一次。1996年9至15岁的参与者，在1996年至2008年期间至少完成了两次连续问卷调查，被纳入分析。参与者被分类为BN（>=每周暴食和排便）、暴食障碍（BED; >=每周暴食，不经常排便）、排便障碍（PD; >=每周排便，不经常排便）、其他EDNOS（每月暴食和/或排便）或无紊乱。结果：青春期女孩受BN影响的比例约为1%；2%到3%的人患有PD，另外2%到3%的人患有BED。患有BED的女孩超重或肥胖的可能性几乎是正常同龄人的两倍（比值比[or]: 1.9[95%可信区间：1.0-3.5]）或出现重度抑郁症状（or: 2.3[95%可信区间：1.0-5.0]）。患有PD的女性参与者开始使用药物（OR: 1.7）和开始频繁酗酒（OR: 1.8）的风险显著增加。结论：PD和BED是常见的，可预测一系列不良结局。初级保健临床医生应该意识到这些疾病，这些疾病在饮食失调的临床样本中可能代表性不足。预防饮食失调的努力应该集中在阈下严重程度的病例上。儿科2012;130: e289-e295
OBJECTIVE: Anorexia nervosa and bulimia nervosa (BN) are rare, but eating disorders not otherwise specified (EDNOS) are relatively common among female participants. Our objective was to evaluate whether BN and subtypes of EDNOS are predictive of developing adverse outcomes.METHODS: This study comprised a prospective analysis of 8594 female participants from the ongoing Growing Up Today Study. Questionnaires were sent annually from 1996 through 2001, then biennially through 2007 and 2008. Participants who were 9 to 15 years of age in 1996 and completed at least 2 consecutive questionnaires between 1996 and 2008 were included in the analyses. Participants were classified as having BN (>= weekly binge eating and purging), binge eating disorder (BED; >= weekly binge eating, infrequent purging), purging disorder (PD; >= weekly purging, infrequent binge eating), other EDNOS (binge eating and/or purging monthly), or nondisordered.RESULTS: BN affected similar to 1% of adolescent girls; 2% to 3% had PD and another 2% to 3% had BED. Girls with BED were almost twice as likely as their nondisordered peers to become overweight or obese (odds ratio [OR]: 1.9 [95% confidence interval: 1.0-3.5]) or develop high depressive symptoms (OR: 2.3 [95% confidence interval: 1.0-5.0]). Female participants with PD had a significantly increased risk of starting to use drugs (OR: 1.7) and starting to binge drink frequently (OR: 1.8).CONCLUSIONS: PD and BED are common and predict a range of adverse outcomes. Primary care clinicians should be made aware of these disorders, which may be underrepresented in eating disorder clinic samples. Efforts to prevent eating disorders should focus on cases of subthreshold severity. Pediatrics 2012;130:e289-e295