[Interplay of social, intrapsychological and biological factors for the etiopathogenesis of anorexia nervosa].

G Ehle
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Abstract

Intergroup-comparison and hierarchical cluster analyses (method Lance and Williams, x2-test, t-test, p less than 5%) of 170 facts at biological, psychodynamic and social level in 35 patients suffering from anorexia nervosa and 30 patients suffering from postpill-amenorrhea confirm the close relations of these levels for aetiopathogenesis. Postpill-amenorrhea can be taken as hypothalamic dysfunction (overpressing of LH-RH-release after anticonceptives) and therefore as a model for the biological disturbance at anorexia nervosa. Cluster analyses resulted in a division into 3 groups: one group of anorexia nervosa (C) with deep biological disturbances; a main group of anorexia nervosa (B) and the group of postpill-amenorrhea (A). In cluster C are combined early age of onset, rigidity-type in hormonal tests, EEG-changes, psychopathic personality in MMPI and strongest disturbed social interactions. In cluster B are neurotic profile in MMPI combined with severe biological and social difficulties. 13 out of 30 showing anorectic-like behaviour during adolescence are even more disturbed as the other postpill-amenorrhea patient in cluster A. Regressions analyses could not confirm a dependence between loss of weight and some endocrine functions.

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神经性厌食症发病的社会、心理和生物因素的相互作用。
35例神经性厌食症患者和30例丸后闭经患者的生物学、心理动力学和社会水平的170项指标的组间比较和分层聚类分析(方法Lance and Williams, x2检验,t检验,p < 5%)证实了这些水平与发病机制的密切关系。避孕药后闭经可视为下丘脑功能障碍(避孕药后lh - rh释放过度),因此可作为神经性厌食症生物学障碍的模型。聚类分析结果将患者分为3组:一组为神经性厌食症(C),伴有深部生物障碍;主要为神经性厌食症组(B)和服药后闭经组(a)。C组包括发病年龄早、激素检查僵硬型、脑电图改变、MMPI精神病人格和强烈的社会交往障碍。B类是MMPI患者的神经质特征,并伴有严重的生理和社会困难。30名在青春期表现出类似厌食行为的患者中,有13名比a组中其他服用避孕药后闭经的患者更受干扰。回归分析不能证实体重减轻与某些内分泌功能之间的依赖关系。
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