Eighty-five per cent of what? Discrepancies in the weight cut-off for anorexia nervosa substantially affect the prevalence of underweight.
Eighty-five per cent of what? Discrepancies in the weight cut-off for anorexia nervosa substantially affect the prevalence of underweight.
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DOI：
10.1017/s0033291708004327
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发表时间：
2009-05
影响因子：
6.9
通讯作者：
Brownell KD
中科院分区：
文献类型：
--
作者：
Thomas JJ;Roberto CA;Brownell KD
DSM-IV引用<85%的预期体重（EBW）作为神经性厌食症（AN）诊断的指导原则，但不要求计算EBW的特定方法。本研究的目的是确定不同研究之间体重临界值计算的差异程度，并评估差异临界值是否导致符合AN诊断的个体患病率差异。两名编码员独立记录了99项研究的EBW计算方法，这些研究要么（a）将AN患者与亚临床饮食失调患者进行比较，要么（B）进行AN治疗试验。将每个体重临界值应用于全国代表性（n = 12001）和寻求治疗（n = 189）样本，以确定EBW计算对符合AN体重标准的比例的影响。编码器确定了10种不同的EBW方法，每种方法都产生了诊断AN的不同权重截止值。虽然只有0.23%的国家样本符合最低临界值，但在最高临界值下，这一数字增加了43倍，达到10.10%。同样，只有48.1%的寻求治疗者达到了最低截止值，而89.4%达到了最高截止值。在确定AN重量临界值方面，研究之间存在相当大的差异。差别待遇大大影响了有资格获得诊断、治疗和保险报销的个人比例。然而，差异可能没有得到充分的理解，因为85%标准的普遍引用创造了一种虚假的共识感。
DSM-IV cites <85% of expected body weight (EBW) as a guideline for the diagnosis of anorexia nervosa (AN) but does not require a specific method for calculating EBW. The purpose of the present study was to determine the degree to which weight cut-off calculations vary across studies, and to evaluate whether differential cut-offs lead to discrepancies in the prevalence of individuals who are eligible for the AN diagnosis. Two coders independently recorded the EBW calculation methods from 99 studies that either (a) compared individuals with AN to those with subclinical eating disorders or (b) conducted AN treatment trials. Each weight cut-off was applied to a nationally representative (n = 12001) and treatment-seeking (n = 189) sample to determine the impact of EBW calculation on the proportion who met the AN weight criterion. Coders identified 10 different EBW methods, each of which produced different weight cut-offs for the diagnosis of AN. Although only 0.23% of the national sample met the lowest cut-off, this number increased 43-fold to 10.10% under the highest cut-off. Similarly, only 48.1% of treatment seekers met the lowest cut-off, whereas 89.4 % met the highest. There is considerable variance across studies in the determination of the AN weight cut-off. Discrepancies substantially affect the proportion of individuals who are eligible for diagnosis, treatment and insurance reimbursement. However, differences may not be fully appreciated because the ubiquitous citation of the 85% criterion creates a sense of false consensus.