常習的万引きを伴う摂食障害の特徴と治療

The Clinical Characteristics of and Treatment for Habitual Shoplifting in Patients with Eating Disorders

抄録

　頻回の万引きを伴う摂食障害の臨床症状と治療を検討した。週に3回以上1年以上の万引きを続け，1年以上の治療を行ったケース8名(男性1名，女性7名)の臨床症状と万引き問題について分析した。対象者の平均年齢は24歳で，全員過食症状を持ち，吐いてやせるanorexia nervosa/binge purging typeが多かった。万引きは食品だけでなく，アクセサリー，衣類などにおよび，全員が警備員に捕まった経験を持ち，半数以上は警察での調書も取られていた。摂食障害と万引きに対する集中的治療を行い，3年後の調査で8名のうち万引きが止まっていた者は5名いて，摂食障害の症状の緩和につれて万引きが減っていた。摂食障害に伴う万引きは，クレプトマニアに近い行動障害と考えられた。

　This study aimed to discover the clinical characteristics of and effective treatment for habitual shoplifting in patients with eating disorders. The subjects were eight patients diagnosed with eating disorders associated with habitual shoplifting. In this study, the criteria for habitual shoplifting comprised three conditions：a frequency of more than 3 times per week, continuation of the shoplifting for more than 1 year, and treatment for more than 1 year at the Kurihama Alcoholism Center. The mean age of the subjects was 23.5 years at the first admission and the mean BMI was 17.2. Out of the subjects, 63% had AN/BP and 75% had personality disorders, with no antisocial personality disorder at the first admission. The mean duration of shoplifting was over 5 years；the shoplifting was not restricted to food but also included accessories and clothing. The subjects had been caught 4 times by the store security guards, and 63% of them had been arrested by the police. We treated them for symptoms of eating disorders and carried out psychotherapies for shoplifting. After 3 years from the first admission, we assessed the condition of their eating disorders and shoplifting. It was found that none of the subjects had recovered from their eating disorders, although there was a slight decrease in abnormal eating behaviors. At the time of referral, five of the eight subjects stopped shoplifting.