社区精神卫生服务机构暴食症的筛查

A. Pieró, Enrica Locati, Francesco Zirilli
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引用次数: 0

摘要

EDNOS(饮食失调症)占所有社区饮食失调病例的四分之三(Bulik et al., 2007)。在EDNOS中,最常见的(Hudson et al., 2007)是暴食症(BED)。BED是一种很好的诊断结构,也是一种稳定的疾病,与精神合并症的升高和社会心理功能的损害有关(Pope et al., 2006)。意大利现有的少数流行病学研究表明,EDNOS的终生患病率为0.64% (Favarelli等人,2006年),而在其他样本中,亚阈值BED和任何暴食的终生估计患病率分别为0.72%和2.15% (Preti等人,2009年)。BED与其他精神疾病诊断的合并症很高:总体而言,73.8%的BED患者一生中额外患有一种精神疾病,43.1%的患者目前至少患有一种精神疾病(Javaras et al., 2008)。虽然通常与肥胖有关,但BED应该被视为一种单独的疾病(Hudson et al., 2007)。在初级保健和普通精神科服务中,这种疾病往往未被发现和治疗(StriegelMoore等人,2010)。Mond等人(2007)的研究表明,只有一小部分BED患者(22.8%)在初级保健机构接受了针对饮食问题的特殊治疗。在MHS中,时间限制通常会阻止临床医生进行用于EDs诊断的临床访谈。问卷作为筛查BED的工具似乎是显而易见的(Freitas et al., 2006)。在可用的工具中,最常用和最有效的工具之一是暴食量表问卷(Gormally et al., 1982)。本研究的主要假设是
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Screening of Binge Eating in a community mental health service
EDNOS (Eating disorder not otherwise specified) accounts for three quarters of all community cases with eating disorders (Bulik et al., 2007). Among EDNOS, the most common (Hudson et al., 2007) is Binge Eating Disorder (BED). BED is a good diagnostic construct and a stable condition, associated with elevated psychiatric comorbidity and impairment in psychosocial functioning (Pope et al., 2006). The few available epidemiological studies in Italy suggest a lifetime prevalence of 0.64% for EDNOS (Favarelli et al., 2006), whereas in other samples lifetime estimated prevalences of sub-threshold BED and any binge eating are 0.72%, and 2.15% respectively (Preti et al., 2009). The comorbidity of BED and other psychiatric diagnoses is high: overall, 73.8% of patients with BED have one additional lifetime psychiatric disorder and 43.1% have at least one current psychiatric disorder (Javaras et al., 2008). Though often associated with obesity, BED should be considered a separate condition (Hudson et al., 2007). This disorder often goes undetected and untreated both in primary care and general psychiatric services (StriegelMoore et al., 2010). Mond et al. (2007) have shown that only a small percentage of subjects with BED (22.8%) receive a specific treatment for eating problems in primary care setting. In MHS, time constraints usually prevent clinicians from administering clinical interviews intended for EDs diagnosis. The utility of questionnaires as a screening for BED seem clear (Freitas et al., 2006). Among available tools, one of the most used and validated is the Binge Eating Scale questionnaire (Gormally et al., 1982). The main assumptions of this study were
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