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:存在两种广泛的神经性贪食症危险因素:那些通常会增加患精神病的风险,以及那些会增加节食风险的因素。预计后者在神经性贪食症患者中尤为常见。

方法:采用病例对照设计,涉及2个综合比较。首先,将102例神经性贪食症患者与204例无饮食失调的健康对照者进行了比较。其次,将相同的102名神经性贪食症患者与102名其他精神疾病患者进行了比较。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:神经性贪食症患者和健康对照组的暴露于大多数推定危险因素的比率有所不同。尽管暴露于可能会增加饮食风险和自我评估风险的因素,以及某些父母问题(包括饮酒障碍),但神经性贪食症患者与其他精神疾病对照组的差异明显较少。结论

结论:这些发现支持以下假设:神经性贪食症是暴露于精神疾病的一般危险因素和饮食风险因素的结果。一个出乎意料的发现是神经性贪食症患者的病前阴性自我评估率特别高,并且存在某些父母问题。

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