Application of a latent class analysis to empirically define eating disorder phenotypes
Application of a latent class analysis to empirically define eating disorder phenotypes
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DOI：
10.1001/archpsyc.61.2.192
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发表时间：
2004-02-01
影响因子：
--
通讯作者：
Kaye, WH
中科院分区：
文献类型：
--
作者：
Keel, PK;Fichter, M;Kaye, WH
内容：饮食失调的诊断标准的影响，我们如何认识，研究和治疗饮食失调，并根据经验有效的表型需要揭示其遗传bases.Objective：经验定义饮食失调phenotypes.Design：数据饮食失调症状和功能从1179个人与临床显著的饮食失调提交了一个潜在的类分析。在一系列验证分析中，对非进食障碍变量进行了比较。设定：多国合作研究，通过不同的临床环境确定病例参与者：招募参与饮食失调遗传研究的受影响亲属对的成员，其中先证者符合DSM-IV-TR神经性厌食症（AN）或神经性贪食症的标准，并且至少有1个生物学亲属患有临床显著的饮食失调。潜在类的数量和临床特征。结果：4类解决方案提供了最佳的拟合。潜伏1类（LC 1）类似于限制AN; LC 2，AN和神经性贪食症，使用多种清除方法; LC 3，限制AN，无强迫症特征; LC 4，神经性贪食症，自我诱发呕吐作为唯一的清除形式。生物亲属很可能属于同一潜在类。在验证分析中，LC 2表现出最高水平的心理障碍，LC 3表现出最低的。结论：强迫症特征的存在与限制AN的个体之间的区别。同样，低体重和多种净化方法的组合区分了暴饮暴食和净化行为的个体。这些结果支持DSM-IV-TR中饮食失调亚型之间的一些区别，同时引入新的特征来定义表型。
Context: Diagnostic criteria for eating disorders influence how we recognize, research, and treat eating disorders, and empirically valid phenotypes are required for revealing their genetic bases.Objective: To empirically define eating disorder phenotypes.Design: Data regarding eating disorder symptoms and features from 1179 individuals with clinically significant eating disorders were submitted to a latent class analysis. The resulting latent classes were compared on noneating disorder variables in a series of validation analyses. Setting: Multinational, collaborative study with cases ascertained through diverse clinical settings (inpatient, outpatient, and community).Participants: Members of affected relative pairs recruited for participation in genetic studies of eating disorders in which probands met DSM-IV-TR criteria for anorexia nervosa (AN) or bulimia nervosa and had at least 1 biological relative with a clinically significant eating disorder.Main Outcome Measure: Number and clinical characterization of latent classes.Results: A 4-class solution provided the best fit. Latent class 1 (LC1) resembled restricting AN; LC2, AN and bulimia nervosa with the use of multiple methods of purging; LC3, restricting AN without obsessive-compulsive features; and LC4, bulimia nervosa with self-induced vomiting as the sole form of purging. Biological relatives were significantly likely to belong to the same latent class. Across validation analyses, LC2 demonstrated the highest levels of psychological disturbance, and LC3 demonstrated the lowest.Conclusions: The presence of obsessive-compulsive features differentiates among individuals with restricting AN. Similarly, the combination of low weight and multiple methods of purging distinguishes among individuals with binge eating and purging behaviors. These results support some of the distinctions drawn within the DSM-IV-TR among eating disorder subtypes, while introducing new features to define phenotypes.