暴食症复原後仍有OCD症状.doc

暴食症復原後仍有OCD症狀作者：Paula Moyer, MD 出處：WebMD醫學新聞審閱：Elizabeth Saenger, PhD May 23, 2006 (多倫多) 根據研究團隊於美國精神醫學學會第159屆年會所發表的研究發現，即使在暴食症緩解且重新恢復正常飲食後，病患仍有強迫症(OCD)症狀。研究主要負責人Jessica C. Morgan 醫師在發表時指出，這些發現補強了有關OCD症狀在暴食症緩解後仍會持續的文獻，因此，OC症狀等級提高或許是暴食症患者的特徵；Morgan 醫師是新罕布夏州漢諾威達特茅斯醫學院兒童及青少年精神病的住院醫師。Morgan 醫師及共同研究者之所以進行此研究，是因為文獻指出妄想與強迫行為是初發作暴食症者共同病態並存的症狀，因此，他們比較暴食症患者和健康者之間的OC症狀等級；研究團隊一開始使用Maudsley強迫量表 (MOCI)讓病患自我評估，然後在病患恢復正常飲食後，再度評估看其是否MOCI值提升。研究團隊從77位沒有服藥、體重正常的女性獲得MOCI分數，其中25位有暴食症、21位正復原中、28是健康對照者，這些婦女之前曾參與有關神經傳導物質功能的研究，同時也都完成飲食態度測試(EAT)和情境-特質焦慮量表(STAI)，分別用來測試異常飲食態度和焦慮異常的可能性。暴食症病患組的MOCI分數是平均5.4 4.4，顯著高於控制組的2.5 1.9 (P .02)，最引人注意的是暴食症婦女復原後的MOCI分數：平均5.5 5.4，此分數和暴食症病患的分數相近，相對的也高於控制組 (P .05)；雖然復原者的EAT和STAI分數顯著低於罹病者，但是仍然顯著高於控制組(P值均 .01)。此研究有一部分受美國公共衛生服務獎助金支持。OCD Symptoms Persist After Rec By Paula Moyer, MDMedscape Medical News May 23, 2006 (Toronto) Even after bulimia is in remission and normal eating has resumed, patients can continue to have symptoms of obsessive-compulsive disorder (OCD), according to investigators who presented their findings here at the 158th annual meeting of the American Psychiatric Association.These findings add to the literature that shows that the OCD symptoms present in people with bulimia persist after remission, said principal investigator Jessica C. Morgan, MD, at her presentation. Therefore, elevated OC ratings may be a persistent trait characteristic of individuals who develop bulimia. Dr. Morgan is a resident in child and adolescent psychiatry at Dartmouth Medical College in Hanover, New Hampshire. Dr. Morgan and coinvestigators conducted the study because the literature had shown that obsessive and compulsive behaviors existed comorbidly alongside the primary symptoms of bulimia nervosa. Therefore, they compared the levels of OC characteristics in individuals with bulimia nervosa and in healthy controls. The investigators used patient self-ratings on the Maudsley Obsessive-Compulsive Inventory (MOCI) at baseline and whether patients continued to have elevated MOCI scores after normal eating behavior was restored.The investigators were able to obtain MOCI scores for 77 medication-free, normal-weight women, 25 of whom had active bulimia nervosa, 21 were in recovery, and 28 were healthy controls. The women had participated in previous studies of neurotransmitter function. The subjects also completed the Eating Attitudes Test (EAT) and the Spielberger Trait Anxiety Inventory (STAI), which respectively tested for disordered eating attitudes and for the possibility of an anxiety disorder.The MOCI scores for patients in the bulimia group averaged 5.4 4.4, which was significantly higher than the scores for the control group, which averaged 2.5 1.9 (P .02). Of particular interest were the MOCI scores for women recovering from bulimia, which averaged 5.5 5.4. These scores were similar to the values for the patients with active bulimia and were, therefore, also elevated compared with control subjects (P .05). Although the recovering subjects scores on EAT and STAI were significantly lower than the scores for those with active disease, they were still significantly higher than for those in the control group (P .01 for each).An expert in eating disorders agreed that the findings will help psychiatrists manage recovering bulimia patients more effectively, and be more aware of which patients may be vulnerable for other difficulties after the bulimia is in remission.The results of this study are consistent with previous findings, David Fassler, MD, told Medscape. Anxiety disordersclearly run in families, and children of parents with anxiety disorders have an increased genetic predisposition to develop the same or related disorders.This study helps identify a subset of people who may be atparticular risk. Dr. Fassler is a clinical professor of psychiatry at the University of Vermont College of Medicine in Burlington.Dr. Fassler stressed that the investigators findings have the potential to enhance early recognition of OCD persisting after a patient recovers from bulimia. In addition, knowing about the confluence of these risks may also lead to new strategiesdesigned toreduce the risk of anxiety disorders in young people with a known family history. The study was supported in part by a grant from the United St