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首页> 外文期刊>The journal of clinical psychiatry >Problems applying the DSM-IV eating disorders diagnostic criteria in a general psychiatric outpatient practice.
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Problems applying the DSM-IV eating disorders diagnostic criteria in a general psychiatric outpatient practice.

机译：在一般精神科门诊实践中应用DSM-IV饮食失调诊断标准的问题。

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OBJECTIVE: A substantial number of patients treated in specialized eating disorder programs fail to meet criteria for anorexia nervosa or bulimia nervosa, the 2 eating disorders with specified criteria in DSM-IV, and are diagnosed with eating disorder not otherwise specified (NOS). In a general psychiatric setting, where the severity of eating pathology is likely to be milder than in specialty programs, we predicted that most patients with disordered eating would fail to meet the full criteria for one of the DSM-IV eating disorders and instead would be diagnosed with eating disorder NOS. METHOD: Two thousand five hundred psychiatric outpatients were interviewed with the Structured Clinical Interview for DSM-IV (SCID) upon presentation for treatment. The findings presented in this report were derived from patients interviewed from December 1995 to August 2006. RESULTS: Thirteen percent (N = 330) of the patients were diagnosed with a lifetime history of an eating disorder, 307 of whom received 1 diagnosis and 23 of whom were diagnosed with 2 disorders. Almost half (N = 164) of the disorders were present at the time of presentation, approximately one sixth (N = 60) were considered to be in partial remission, and slightly more than one third (N = 129) were past diagnoses. When binge-eating disorder was combined with the other forms of eating disorder NOS, as it is in DSM-IV, 90.2% (148/164) of the patients with a current eating disorder were diagnosed with eating disorder NOS. CONCLUSIONS: The preponderance of eating-disordered patients in a general psychiatric setting were diagnosed with eating disorder NOS. This finding suggests that there is a problem with the clinical applicability of the diagnostic criteria in the DSM-IV eating disorder category.
机译：目的：在专门的进食障碍计划中接受治疗的许多患者均未达到神经性厌食症或神经性贪食症的标准，这是DSM-IV中指定标准的2种进食障碍，并且被诊断患有未另行指定的进食障碍（NOS）。在一般的精神病学环境中，进食病理的严重程度可能比专科计划要轻一些，我们预测大多数进食障碍的患者将无法满足DSM-IV进食障碍之一的完整标准，反而会被诊断患有进食障碍NOS。方法：在介绍治疗方法后，对2500名精神科门诊患者进行了针对DSM-IV（SCID）的结构化临床访谈。本报告中的发现来自于1995年12月至2006年8月间接受访谈的患者。结果：13％（N = 330）的患者被诊断出有饮食失调的终生史，其中307例接受了1次诊断，23例被诊断为饮食失调。他们被诊断出患有2种疾病。在就诊时几乎有一半（N = 164）的疾病存在，大约六分之一（N = 60）被认为部分缓解，过去的诊断略多于三分之一（N = 129）。当暴饮暴食症与其他形式的饮食失调症NOS合并时，就像在DSM-IV中一样，当前有饮食失调症的患者中90.2％（148/164）被诊断为饮食失调症。结论：一般精神病患者中饮食失调患者占多数，被诊断为饮食失调症。该发现表明在DSM-IV饮食失调类别中诊断标准的临床适用性存在问题。

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