ABSTRACT

The assessment and diagnosis of atypical anorexia nervosa (AAN) is an ongoing challenge for clinicians. This study aims to examine psychological morbidity and exposure to childhood adversity in adolescents with AAN compared to adolescents with anorexia nervosa, restricting type (AN-R). This registry-based study compared 42 adolescents with AAN to 79 adolescents with AN-R on a variety of psychosocial measures at the time of presentation to a specialized eating disorder program. In contrast to AN-R, adolescents with AAN had more severe drive for thinness (p =.011), body dissatisfaction (p =.038), and lower quality of life (p =.047), but had better global functioning (p =.032). Adolescents who had high Adverse Childhood Experiences (ACE) Questionnaire scores (ACE score ≥ 4) had over 5 times higher odds of having AAN than those who did not have high ACE scores (p =.008). There was no significant difference between groups on measures of low self-esteem and non-accidental self-injury. Adolescents with AAN presented with similar or more severe psychosocial distress compared to their peers with AN-R across a majority of the measures. The findings highlight the need to address trauma, body-related difficulties, and quality of life in the assessment and treatment of adolescents with AAN.

摘要

非典型神经性厌食症 (AAN) 的评估和诊断是临床医生面临的持续挑战。本研究旨在比较 AAN 青少年与限制型厌食症 (AN-R) 青少年的心理发病率和童年逆境暴露情况。这项基于注册的研究比较了 42 名患有 AAN 的青少年和 79 名患有 AN-R 的青少年在参加专门的饮食失调项目时的各种心理社会措施。与 AN-R 相比，患有 AAN 的青少年有更强烈的消瘦 ( p =.011)、身体不满意 ( p =.038)和较低的生活质量 ( p =.047)，但具有更好的整体功能 ( p =.047)。 p=.032)。具有高不良童年经历 (ACE) 问卷评分（ACE 评分 ≥ 4）的青少年患 AAN 的几率是 ACE 评分不高的青少年的 5 倍以上（p =.008）。在低自尊和非意外自伤方面，各组之间没有显着差异。在大多数测量中，与患有 AN-R 的同龄人相比，患有 AAN 的青少年表现出相似或更严重的社会心理困扰。研究结果强调了在评估和治疗患有 AAN 的青少年时需要解决创伤、身体相关困难和生活质量问题。