Research On The Association Between The Family Functioning Of Female Patients With Anorexia Nervosa And Their Clinical Symptoms

Objectives: By analysising the characteristics about the familyfunctioning of patients who suffer from anorexia nervosa under the Chinesecultural background and exploring the relationship between familyfunctioning and the patients’ clinical symptoms, this research intend toprovide references for the effective implementation of the family treatment.Methods: The research employs the case control study method,collecting136patients with AN in clinics or hospitals, corresponding165healthy people with the same gender, age, education level and the marriagestatus,85AN families and123HC families. Tests were carried out on thetwo groups with the method of general demography questionnaire, eatingdisorders assessment scale (EDI-II), family functioning assessment scale(FAD), emotion related scale (HAMD, HAMA), Symptom Checklist (SCL-90), meanwhile, an evaluation on the FAD of some objectives’ parents was carried out. Make a statistical description and analysis of data; compare thedifferences between the AN group and the control group, as well as thedistinctions of the family functioning in different levels within AN group;compare the evaluation of family members towards family functioning;make a further exploration of the relativity between the family functioningand clinical symptoms related with the eating by the method of personcorrelation analysis method; Use two-dimension logistic regression analysismethod and multiple stepwise regression method to make out the risk factorsof family functioning which affect outbreak of AN and degree of severity ofthe specificity of psychosomatic symptoms.Results:1. Compared with control groups, the AN group shows no significantdifference in gender, age, education level and marriage status.(p>0.05).2. Patients with AN have a higher score than the control group in thecommunication of family functioning, roles and affective responsiveness,affective involvement as well as the general functioning[（20.92±4.331）vs（18.32±3.241），（25.06±3.996）vs（23.25±3.457），（14.02±2.946）vs（13.50±2.189），（16.54±3.301）vs（14.62±2.395），（25.85±6.172）vs（22.71±4.591）, P<0.05]. By contrast with the short duration group, thelong duration group has a higher score in communication and the general function [（20.04±4.114） vs （21.69±4.323），（24.30±5.388） vs（27.18±6.546），average P<0.05]; compared with the families with amedium and high incomes, the families with the monthly income per headbelow1000yuan rate higher score in communication and generalfunctioning [（22.69±5.11） vs （20.96±3.74），（29.31±5.65） vs（25.52±6.91），P<0.05]; It is not discovered that there are any statisticalsignificance varieties in families with differences of disease subtypes, timeof the disease onset and the severity of the disease（p>0.05）.3. When carrying out a comparison of FAD score among differentmembers of a family, that daughters in AN group have a significantly higherscore(21.38±4.52， P<0.001) than their parents in communication subscalewhile the parents do not show a clear difference (p>0.05). The daughters incontrol group have a remarkable higher score（23.35±3.74， P<0.05） thantheir parents on general functioning but their parents have no obviousdistinction(p>0.05).4. There exists in AN patients a positive correlation statisticallybetween the problem solving, communication, roles subscale in FAD scaleand EDI-II general scores, ineffectiveness, interpersonal distrust, socialinsecurity factors(0.220≤r≤0.719，P＜0.05or P＜0.01), beyond whichthere is a positive correlation in statistical significance between roles subscale and asceticism factor （r＝0.237， P＜0.05). Affectiveresponsiveness and interpersonal distrust and social insecurity factor showthe positive correlation in statistical significant （r＝0.441，P＜0.01；r＝0.399，P＜0.01). As to the result of the FAD, there is a broad correlationbetween four aspects overall, the problem solving, communications, rolesand the general function, and the SCL-90total scores as well as scores offactors, HAMA total scores, HAMD total scores, in addition, all thecorrelations are statistically significant （0.186≤r≤0.392，P＜0.05或P＜0.01）. The EDI-II total score and scores of factors, SCL-90total score aswell as its scores of factors, HAMA total scores, HAMD total scores possessthe statistically correlation（0.200≤r≤0.742，P＜0.05or P＜0.01）.5. With the aid of the Logistic regression analysis, it is found that theFAD problem solving factor is risk factor for the onset of AN (OR=1.751,p=0.007) while the affective involvement is the protective factor (OR=0.637,p=0.002). The multi-stepwise regression analysis reveals the entrance of fourfactors: the communication, the affective responsiveness, the affectiveinvolvement and the general functioning into the regressive equation（0.319≤β≤0.882), which are the core risk factors influencing the scores ofeach subscales.Conclusions: 1.The mental health condition of AN patients is distinctly bad. Thereexists severe malfunction of family functioning in the families of ANpatients. Meanwhile the daughters’ complain is more severe than theirparents. Patients of long-duration of illness and families with poor economicstatus behave worse in communication and general functioning. The patientswith poorer family functioning have a more severe degree of eating disorderbehaviors and pathological psychological characteristics, at the same timeinfluencing each other and making the situation worse.2. The inefficiency of the family problem solving ability plays as a vitalrisk factor in the onset of AN while the affective involvement is a protectivefactor. The dysfunction of the family internal communication, affectiveresponsiveness, affective involvement as well as the family generalfunctioning acts as the most important risk factor which makes thecharacteristic psychosomatic symptoms worse.