BACKGROUND:Many apparently disparate risk factors have been implicated as causes of eating disorders. This study was designed to test the hypothesis that 2 broad classes of risk factors exist for bulimia nervosa: those that increase the risk for development of a psychiatric disorder in general and those that increase the risk of dieting. It was predicted that the latter are especially common among persons with bulimia nervosa.

METHODS:A case-control design was used involving 2 integrated comparisons. First, 102 subjects with bulimia nervosa were compared with 204 healthy control subjects without an eating disorder. Second, the same 102 subjects with bulimia nervosa were compared with 102 subjects with other psychiatric disorders. To reduce sampling bias, the subjects were recruited directly from the community. A broad range of putative risk factors was assessed.

RESULTS:The subjects with bulimia nervosa and the healthy control subjects differed in their rates of exposure to most of the putative risk factors. Far fewer differences were evident between the subjects with bulimia nervosa and the control subjects with other psychiatric disorders, although exposure to factors that were likely to increase the risk of dieting and to negative self-evaluation and certain parental problems (including alcohol use disorder) were substantially more common among those with bulimia nervosa.

CONCLUSIONS:The findings support the hypothesis that bulimia nervosa is the result of exposure to general risk factors for psychiatric disorder and risk factors for dieting. An unexpected finding was the particularly high rates of premorbid negative self-evaluation and certain parental problems among those with bulimia nervosa.

译文

背景 : 许多明显不同的危险因素被认为是饮食失调的原因。这项研究旨在检验以下假设: 神经性贪食症存在两大类危险因素: 通常增加精神疾病发展风险的因素和增加节食风险的因素。据预测,后者在神经性贪食症患者中尤其常见。
方法 : 使用了涉及2个综合比较的病例对照设计。首先,将102名患有神经性贪食症的受试者与204名没有进食障碍的健康对照受试者进行比较。其次,将患有暴食症的相同102受试者与患有其他精神疾病的102受试者进行比较。为了减少抽样偏差,直接从社区招募了受试者。评估了广泛的推定危险因素。
结果 : 患有神经性贪食症的受试者和健康对照受试者在暴露于大多数推定危险因素的比率上有所不同。神经性贪食症的受试者与其他精神疾病的对照受试者之间的差异要少得多,尽管暴露于可能增加节食风险的因素以及负面的自我评估和某些父母问题 (包括酒精使用障碍) 在神经性贪食症患者中更为普遍。
结论 : 研究结果支持以下假设: 神经性贪食症是暴露于精神疾病的一般危险因素和节食的危险因素的结果。一个意想不到的发现是,在神经性贪食症患者中,病前负面自我评估和某些父母问题的发生率特别高。

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