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患者,女性,17岁,因“厌食3+年,情绪低落7+月,伴暴食、催吐4+月”入院。3+年前患者因便秘开始逐渐减少食量,以减少主食及肉类为主,体质量逐渐减轻,患者观念随即改变,认为越瘦越美,每日吃很少的主食,几乎不吃肉类及油腻食物,计算摄入的热量。患者十分关注自己的体重,每日多次照镜子。1+年前患者体质量较节食前减轻约15kg,虽然已经很瘦,但仍认为自己很胖,认为吃下去的东西全都变成脂肪长在了身上。

Background: Traumatic Events (TEs) are often seen as risk factors not only for the development of eating disorders (EDs) but also for their impact on the severity of clinical presentation and psychiatric comorbidities. Objective: This study aimed to assess the prevalence and time of occurrence of TEs in the two subtypes of anorexia nervosa (AN; restricting [RAN] and binge-purging [BPAN]) and to investigate differences in TEs (number, type, frequency) as well as clusters of post-traumatic symptoms and emotional dysregulation between the two groups. Method: Seventy-seven hospitalized women were recruited and divided into two subgroups according to their AN subtype. Participants completed the following self-reported measures: Eating Disorder Inventory-2 (EDI-2), Life Events Checklist (LEC), Impact of Events Scale-Revised (IES-R) and the Difficulties in Emotion Regulation Scale (DERS). Results: A higher occurrence of TEs was found in patients with BPAN than in those with RAN. In particular, there were significantly more women in the BPAN group than in the RAN group who had been sexually assaulted. Exposure to TEs happened before the onset of illness in most patients, regardless of the AN subtype. Finally, the BPAN group had significantly higher scores in terms of post-traumatic symptoms and emotional dysregulation than RAN patients. Conclusions: Patients with BPAN showed a higher occurrence of TEs, post-traumatic symptom clusters, and emotional dysregulation than those with RAN. These findings are of interest as treatments could benefit from trauma-informed interventions for those affected by AN, and particularly for those with the binge-purging subtype. * Traumatic events are common among patients with both subtypes of anorexia nervosa.* Higher number and occurrence of TEs were found in patients with binge-purging anorexia nervosa than those with the restricter subtype.* Patients with binge-purging anorexia nervosa reported higher post-traumatic symptoms and emotion dysregulation than those with the restricter subtype.