A naturalistic, long-term follow-up of purging disorder.
A naturalistic, long-term follow-up of purging disorder.
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DOI：
10.1017/s0033291719003982
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发表时间：
2021-04
影响因子：
6.9
通讯作者：
Keel PK
中科院分区：
文献类型：
--
作者：
Forney KJ;Crosby RD;Brown TA;Klein KM;Keel PK
DSM-5引入了净化障碍作为另一种特定的喂养或进食障碍，其特征是在没有暴饮暴食的情况下反复净化。目前的研究试图描述净化障碍的长期结果，并检查结果的预测因素。符合净化障碍研究标准的女性（N = 84）完成了一系列全面的基线访谈和问卷评估。在平均10.24（3.81）年的随访中，可用记录显示所有女性均存活，超过95%的女性（n = 80）成功定位，超过三分之二（n = 58）完成了随访评估。进食障碍状态、完全恢复状态和进食病理水平作为结果进行检查。严重程度和合并症指标作为预后的预测指标进行了测试。虽然女性在临床上经历了全球饮食病理学的显著减少，但58%的女性在随访时继续符合DSM-5饮食障碍的标准。只有30%符合完全恢复的既定标准。女性报告在排泄频率，体重和形状的关注，认知抑制显着减少，但没有报告抑郁和焦虑症状显着减少。生活质量在生理、心理和社会领域受损。基线时更严重的体重和体型问题预测在随访时符合饮食失调的标准。其他基线严重程度指标和合并症不能预测结局。结果突出的严重性和慢性泻下障碍作为一个临床上显着的进食障碍。未来的工作应该检查维护因素，以更好地适应治疗清除障碍。
The DSM-5 introduced purging disorder as an other specified feeding or eating disorder characterized by recurrent purging in the absence of binge eating. The current study sought to describe the long-term outcome of purging disorder and to examine predictors of outcome. Women (N = 84) who met research criteria for purging disorder completed a comprehensive battery of baseline interview and questionnaire assessments. At an average of 10.24 (3.81) years follow-up, available records indicated all women were living, and over 95% were successfully located (n = 80) while over two-thirds (n = 58) completed follow-up assessments. Eating disorder status, full recovery status, and level of eating pathology were examined as outcomes. Severity and comorbidity indicators were tested as predictors of outcome. Although women experienced a clinically significant reduction in global eating pathology, 58% continued to meet criteria for a DSM-5 eating disorder at follow-up. Only 30% met established criteria for full recovery. Women reported significant decreases in purging frequency, weight and shape concerns, and cognitive restraint, but did not report significant decreases in depressive and anxiety symptoms. Quality of life was impaired in the physical, psychological, and social domains. More severe weight and shape concerns at baseline predicted meeting criteria for an eating disorder at follow-up. Other baseline severity indicators and comorbidity did not predict outcome. Results highlight the severity and chronicity of purging disorder as a clinically significant eating disorder. Future work should examine maintenance factors to better adapt treatments for purging disorder.