GASTROINTESTINAL DISTURBANCE IN ANOREXIA-NERVOSA
GASTROINTESTINAL DISTURBANCE IN ANOREXIA-NERVOSA
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DOI：
10.1136/pgmj.61.711.3
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发表时间：
1985-01-01
影响因子：
5.1
通讯作者：
CRISP, AH
中科院分区：
文献类型：
--
作者：
CRISP, AH
神经性厌食症似乎是一种应对生活的尝试。局外人很难认识到，它的物理和生物扭曲，实际上是一个寻求和激烈捍卫的避难所。为此，厌食者会隐瞒她紊乱的任何方面，如果这些方面的披露会危及她的立场。难怪这种情况经常被完全忽略。它与酒精中毒等其他自律性障碍有相同的区别。随着人们的注意力集中在这种疾病的一些不可避免的、有时甚至是罕见的方面，不可避免地存在着滋生新的和本质上站不住脚的综合症的肥沃土壤。正确的诊断似乎有几个层面。首先，骨瘦如柴的年轻女性的行为表现综合症--通常在远处很明显--带有饥饿的污点，其中包括对食物的无休止关注，以及她无休止地防止摄入食物的需要。第二，潜在的、但基本的和明显不自然的肥胖恐惧的存在，以及青春期成熟危机的性质，这种危机已经导致了这种障碍，现在似乎通过它被避免了(Crisp，1980)。严重的神经性厌食症相当常见，大约每200名十几岁的女性中就有一人受到影响。这种情况的心理主因决定了各种和深刻的身体功能障碍，这些障碍会出现并持续存在，而这一点在胃肠道中最为戏剧性。
Anorexia nervosa would seem to be an attempt to cope with life. It is hard for the outsider to recognize that the physical and biological distortions which characterize it are, in fact, a sought-for and fiercely defended refuge. To this end the anorectic will conceal any of those aspects of her disorder the revelation of which would jeopardise her stance. It is small wonder that the condition is often missed altogether. It shares this distinction with other egosyntonic disorders such as alcoholism. With attention focussed on some inescapable, and sometimes rare, aspect of the condition, there is inevitably a fertile soil for the spawning ofnew and essentially falsely founded syndromes. The correct diagnosis would seem to have several levels to it. Firstly, the behavioural expressive syn-drome-often evident at a distance-of the emaciated young female with the stigmata of starvation and which will include endless preoccupation with food and her endless need to defend against ingesting it. Secondly, the presence of the underlying often denied but fundamental and apparently unnatural terror of weight gain and its attendant'fatness', and thirdly, the nature of the adolescent maturational crisis which has precipitated out the disorder and which it seems is now, through it, being avoided (Crisp, 1980). Severe anorexia nervosa isquite common, affecting aboutone in 200ofteenage females. The psychological mainsprings of the condition determine the various and profound disturbances of bodily function that arise and persist and nowhere is this more dramatic than within the gastrointestinal tract.