目的:由于神经性正食症(ON)一词是从希腊语中创造出来的(ρθ↔,右和ρεζι,食欲)在1997年描述了对“正确”饮食的痴迷,它在世界范围内使用,没有一致的定义。尽管多位作者提出了诊断标准,发表了许多理论论文,没有关于ON的共识定义,经验的主要证据是有限的,和ON不是一个标准化的诊断。这些差距阻碍了确定风险和保护因素的研究,病理生理学,功能后果,和循证治疗。本研究的目的是对饮食失调领域的专家对ON病理学的常见观察和介绍进行分类,提出初步诊断标准,并考虑哪个DSM章节和类别最适合ON是否包含在内。
方法:来自四大洲14个不同国家的47名饮食失调研究人员和多学科治疗专家完成了一个三阶段改进的德尔菲过程。75%的同意被确定为将声明纳入最终共识文件的阈值。在第一阶段,参与者通过在线调查被要求同意或不同意关于ON的四类67项声明:A-Definition,临床方面,持续时间;B-后果;C-发病;D-排除标准,并评论他们的理由。回应被用来修改陈述,然后在第二阶段提供给相同的参与者,第二轮反馈,再次以在线调查的形式。对第二阶段的回应被用来修改和改进第三阶段的陈述,其中提供了符合协议阈值的预定75%的陈述,供所有参与者进行审查和评论。
结果:27项声明达到或超过共识阈值,并被编入建议的ON诊断标准。
结论:这是第一次在全球范围内制定ON的标准化定义,多学科专家队列。它代表了观察结果的总结,临床专业知识,以及来自广泛知识基础的研究结果。它可以用作诊断的基础,治疗方案,并进一步研究以回答仍然存在的悬而未决的问题,特别是ON的功能后果,以及如何在早期阶段预防或识别和干预。尽管参与者涵盖了许多国家和学科,需要进一步的研究来确定这些诊断标准是否适用于当前专家小组中未代表的地理区域中的ON经验.
方法:V级:专家委员会的意见。
OBJECTIVE: Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with \"correct\" eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no
consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included.
METHODS: 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final
consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A-Definition, Clinical Aspects, Duration; B-Consequences; C-Onset; D-Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants.
RESULTS: 27 statements met or exceeded the
consensus threshold and were compiled into proposed diagnostic criteria for ON.
CONCLUSIONS: This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel.
METHODS: Level V: opinions of expert committees.