目的:关于非典型神经性厌食症(AN)相对于AN和神经性贪食症(BN)的症状的自然过程的研究是有限的,但需要告知病理学和提高对非典型AN的认识。这项研究旨在1)表征进食障碍和内化(焦虑,抑郁症)有和没有非典型AN病史的大学生的症状,AN,和BN;和2)比较各组的性别和种族/民族分布。
方法:参加了SpitforScience™的美国大学生,前瞻性队列研究,被归类为具有非典型AN病史(n=125),AN(n=160),BN(n=617),或作为非进食障碍对照(NC,n=5876)。广义和线性混合效应模型评估了饮食和内化症状轨迹的群体差异,和逻辑回归比较了各组的性别和种族/民族分布。
结果:与大学期间的NC相比,非典型AN参与者表现出进食障碍和内化症状升高,但症状不如AN和BN参与者严重。尽管所有饮食失调组都在禁食和驱动运动方面表现出改善的迹象,净化和抑郁仍然升高。与AN和/或BN参与者相比,非典型AN参与者表现出焦虑增加和稳定的暴饮暴食轨迹。非典型AN组的有色人种明显多于AN组。
结论:研究结果强调非典型AN是一种严重的精神疾病。由于非典型AN可能比AN和BN表现得更轻,并且不成比例地影响有色人种,临床医生应注意可能延误诊断和治疗的偏见.
■有非典型AN历史的大学生,AN,和BN在禁食和驱动运动以及稳定的清除和抑郁水平方面表现出改善。与AN和BN学生的有利变化相比,非典型AN学生表现出焦虑和稳定的暴饮暴食轨迹恶化。非典型AN的百分比较高(与AN)学生是有色人种。研究结果可以提高大学生非典型AN的检出率。
OBJECTIVE: Research on the natural course of symptoms of atypical anorexia nervosa (AN) relative to AN and bulimia nervosa (BN) is limited yet needed to inform nosology and improve understanding of atypical AN. This study aimed to 1) characterize trajectories of eating disorder and internalizing (anxiety, depression) symptoms in college students with and without a history of atypical AN, AN, and BN; and 2) compare sex and race/ethnicity distributions across groups.
METHODS: United States college students who participated in Spit for Science™, a prospective cohort study, were classified as having a history of atypical AN (n = 125), AN (n = 160), BN (n = 617), or as non-eating-disorder controls (NCs, n = 5876). Generalized and linear mixed-effects models assessed group differences in eating and internalizing symptom trajectories, and logistic regression compared groups on sex and race/ethnicity distributions.
RESULTS: Atypical AN participants demonstrated elevated eating disorder and internalizing symptoms compared to NCs during college, but less severe symptoms than AN and BN participants. Although all eating disorder groups showed signs of improvement in fasting and driven exercise, purging and depression remained elevated. Atypical AN participants showed increasing anxiety and stable binge-eating trajectories compared to AN and/or BN participants. The atypical AN group comprised significantly more people of color than the AN group.
CONCLUSIONS: Findings underscore that atypical AN is a severe psychiatric disorder. As atypical AN may present as less severe than AN and BN and disproportionately affects people of color, clinicians should be mindful of biases that could delay diagnosis and care.
UNASSIGNED: College students with histories of atypical AN, AN, and BN demonstrated improvements in fasting and driven exercise and stable purging and depression levels. Atypical AN students showed worsening anxiety and stable binge-eating trajectories compared to favorable changes among AN and BN students. A higher percentage of atypical AN (vs. AN) students were people of color. Findings may improve the detection of atypical AN in college students.