精神医学48巻4号

2006年04月発行

展望

摂食障害

著者： 切池信夫¹

所属機関： ¹大阪市立大学大学院医学研究科神経精神医学

ページ範囲：P.356 - P.369

文献概要

はじめに

　摂食障害は，主に神経性食思不振症(anorexia nervosa, AN)と神経性過食症(bulimia nervosa, BN)からなる。ANは身体像の障害，強いやせ願望や肥満恐怖などのため不食や摂食制限，あるいは過食しては嘔吐するため，著しいやせと種々の身体・精神症状を生じる一つの症候群である。BNは，自制困難な摂食の欲求を生じて，短時間に大量の食物を強迫的に摂取しては，その後嘔吐や下剤の乱用，翌日の摂食制限，不食などにより体重増加を防ぎ，体重はANほど減少せず正常範囲内で変動し，過食後に無力感，抑うつ気分，自己卑下をともなう一つの症候群である。これらの摂食障害が思春期から青年期の女性を中心に急増し，さらには前思春期の児童から結婚後に発症する例も増加し，その臨床像も多様かつ複雑化してきている。そこで本稿では，まず摂食障害の疫学について紹介し，次に心理・社会的研究と生物学的研究，臨床像を複雑化しているcomorbidity，診断と治療法，さらに転帰に関する主な研究の現況を紹介し，これらの問題点や今後の課題について私見を述べる。

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