神経性食欲不振症の臨床像に関する集計的研究

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Statistical studies on the clinical picture of anorexia nervosa were carried out. A preliminary investigation established that criteria for the diagnosis of anorexia nervosa can be defined as follows;1. loss of more than 20% of standard body weight, 2. a history of weight loss for more than three months, 3. age of onset less than 30 years of age, 4. female, 5. amenorrhea, 6. eating disturbances, 7. desire to reduce body weight, 8. hyperactivity, 9. denial of the existence of disease, 10. absence of evidence of organic disease or endogenous psychiatric disease.A typical case is a patient who fills all of these ten criteria. The patient who fills criteria numbers 1,2 and 10 is termed an atypical case.In the present investigation, detailed data on the 47 typical and the 186 atypical patients, a total of 233 cases, were collected from thirty five univertsity hospital throughout Japan. The incidence of signs, symptons, laboratory data, endocrinological data and data of hypothalamo-pituitary function tests was inverstigated. Among the signs, the incidence of bradycardia and hypertiricosis showed significant difference between the typical and the atypical cases. These signs are useful for the diagnosis of anorexia nervosa. Factor analysis of the symptoms of anorexia nervosa was carried out using a computer.Most patients had certain endocrinological abnormalities especially in hypotalamo-pituitary function. Statistical studies indicate that at least some of the abnormalities such as abnormal value of serum growth hormone might be secodnary changes due to the weight loss itself.However, other abnormalities such as an abnormal luteinizing hormone secretion might be due to hypothalamic dysfunciton.In the clinical course of the disease, 7 patients out of 233 studied, died including three (6.4%) of the 47 typical cases.These studies were supported in part by the Research Grant for Ministry of Health and Welfare of Japan.
日本心身医学会の論文
1980-06-01

神経性食欲不振症の臨床像に関する集計的研究

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