目的:本研究旨在全面报道儿童和青少年非典型神经性厌食症(AAN)的流行病学和临床特征。
方法:2024年5月,使用Medline进行了系统评价,科克伦图书馆,ClinicalTrials.gov,和相关网站。按照PRISMA准则,筛选了234篇关于DSM-5定义的AAN的研究。在评估方法中采用了标准化的清单-JBI关键评估工具,13项保留的研究通过了筛选和关键评估程序,以进行最终审查。纽卡斯尔-渥太华量表用于评估队列和病例对照研究中的偏倚风险。确保方法学质量的全面评价。
结果:年轻年龄组的AAN患病率为2.8%,在8年内累积2.8%的发病率。发病率为每10万人年366例,平均发作时间为11.6个月,缓解率为71%。AAN的诊断持久性不如其他限制性进食和进食障碍(FED)稳定。AAN个体表现出更高的EDE-Q分数,更严重的痛苦,与神经性厌食症患者和对照组相比,BMI差异明显。从DSM-IV到DSM-5的诊断过渡表明AAN患者主要是女性,稍微老一点,和更高的重量。
结论:这项研究对发育时代的AAN特征产生了具体的见解,突出人口差异,临床表现,和治疗结果。认识到AAN个人面临的独特挑战对于定制有效的干预措施和改善FED范围内的整体护理至关重要。
OBJECTIVE: This study aimed to comprehensively report the epidemiological and clinical features of atypical anorexia nervosa (AAN) in children and adolescents.
METHODS: In May 2024, a systematic
review was performed using Medline, Cochrane Library, ClinicalTrials.gov, and relevant websites. Following PRISMA guidelines, 234 articles were screened for studies on DSM-5-defined AAN. A standardized checklist-the JBI critical appraisal tool-was adopted in assessing methodology, and 13 retained studies passed the screening and critical appraisal process for the final
review. The Newcastle-Ottawa Scale was utilized to assess the risk of bias in cohort and case-control studies, ensuring a comprehensive evaluation of methodological quality.
RESULTS: AAN prevalence in young age groups is 2.8%, with a cumulative 2.8% incidence over 8 years. Incidence is 366 per 100,000 person-years, and the average episode duration is 11.6 months, with a 71% remission rate. Diagnostic persistence for AAN is less stable than other restrictive feeding and eating disorders (FEDs). AAN individuals exhibit higher EDE-Q scores, more severe distress, and distinct BMI differences compared to those with anorexia nervosa and controls. The diagnostic transition from the DSM-IV to the DSM-5 shows that AAN patients are predominantly female, slightly older, and with higher weight.
CONCLUSIONS: This study yields concrete insights into the features of AAN in the developmental age, highlighting demographic variations, clinical presentations, and treatment outcomes. Recognizing the unique challenges faced by AAN individuals is vital for tailoring effective interventions and improving overall care within the FED spectrum.