Gaudiani et al. (2022) presented terminal anorexia nervosa (T-AN) as a potential new specifier to the anorexia nervosa (AN) diagnosis, with criteria including (a) AN diagnosis, (b) age > 30 years, (c) previously participated in high-quality care, and (d) the clear, consistent determination by a patient with decision-making capacity that additional treatment would be futile, knowing death will result. This study's purpose was to empirically examine a subgroup of participants with AN who met the first three criteria of T-AN-and a smaller subset who also met a proxy index of the fourth criterion involving death (TD-AN)-and compare them to an adult "not terminal" anorexia nervosa (NT-AN) group and to a "not terminal" subset 30 years of age or older (NTO-AN). Patients at U.S. eating disorder treatment facilities (N = 782; T-AN: n = 51, TD-AN: n = 16, NT-AN: n = 731, NTO-AN: n = 133), all of whom met criteria for a current Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnosis of AN, were compared regarding admission, discharge, and changes from admission to discharge on physiological indices (i.e., white blood cell counts, albumin levels, aspartate aminotransferase levels, and body mass index), as well as self-report measures (i.e., eating disorder, depression, anxiety, and obsessive-compulsive symptoms). In contrast to the tight syndromal symptom interconnections of, and inevitable spiral toward death expected for, a terminal diagnosis, results suggest substantial variability within the T-AN group and TD-AN subset, and an overall trend of improvement across physiological and self-report measures. This study thus provides some empirical evidence against the specification of the T-AN diagnosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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“神经性厌食症晚期”可能不是晚期：实证评估。


高迪亚尼等人。 (2022) 将终末期神经性厌食症 (T-AN) 作为神经性厌食症 (AN) 诊断的潜在新指标，其标准包括 (a) AN 诊断，(b) 年龄 > 30 岁，(c) 之前参加过高- 高质量的护理，以及 (d) 具有决策能力的患者清楚、一致地确定，额外的治疗将是徒劳的，因为他们知道会导致死亡。本研究的目的是根据经验检查符合 T-AN 前三个标准的 AN 参与者亚组，以及也满足涉及死亡的第四个标准 (TD-AN) 的代理指数的较小亚组，并将它们与成人“未终末期”神经性厌食症 (NT-A​​N) 组和 30 岁或以上的“未终末期”子集 (NTO-AN)。美国饮食失调治疗机构的患者（N = 782；T-AN：n = 51；TD-AN：n = 16；NT-AN：n = 731；NTO-AN：n = 133），全部符合标准现行《精神疾病诊断与统计手册》第五版对 AN 的诊断进行了比较，包括入院、出院以及从入院到出院的生理指标（即白细胞计数、白蛋白水平、天冬氨酸转氨酶水平和身体指标）的变化。质量指数），以及自我报告措施（即饮食失调、抑郁、焦虑和强迫症状）。与最终诊断之间紧密的综合征症状相互关联以及不可避免的螺旋式走向死亡相反，结果表明 T-AN 组和 TD-AN 子集内存在显着差异，并且生理和自我报告的整体改善趋势措施。因此，本研究提供了一些反对 T-AN 诊断规范的经验证据。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。