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Exploring Reciprocal Associations Between Self-Reported Anxiety and Eating Disorder Symptoms Longitudinally: A Bivariate Latent Change Score Approach. 纵向探索自述焦虑与进食障碍症状之间的相互关联:双变量潜在变化评分法
IF 4.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-16 DOI: 10.1002/eat.24329
Erin E Reilly, Tiffany A Brown, Christopher R DeJesus, Walter H Kaye, Christina E Wierenga

Objective: Consistent data support an association between anxiety and eating disorders (EDs), and theoretical models of EDs suggest that anxiety may be involved in the etiology and maintenance of ED symptoms over time. However, the directionality of relations between these variables remains under-characterized, particularly within treatment settings.

Method: We used bivariate latent change score models to explore longitudinal associations between anxiety and ED symptoms in a sample of ED patients (N = 548, 93.2% female, Mage = 21.16, 78.8% White, 79.6% Non-Hispanic/Latinx) throughout intensive treatment and at 6- and 12-month follow-up.

Results: Best-fitting models exploring change in each variable independently (i.e., univariate models) suggested that changes in ED and anxiety symptoms decreased over time, but that change was influenced by an individual's symptom severity at the previous timepoint. Models exploring associations between changes in both variables over time (i.e., bivariate latent change score models) suggested the best fit for a model where both anxiety and ED symptoms at one timepoint were associated with later change in the other. Specifically, parameters within these models suggested that higher levels of anxiety were associated with increased subsequent reductions in ED symptoms, whereas elevations in ED symptoms were associated with decreased later reductions in anxiety.

Conclusions: Our findings suggest that anxiety and ED symptoms are intricately related both within and outside of intensive treatment. Future multi-modal research exploring real-time links between anxiety and ED symptoms throughout treatment is critical to extend this work and inform improvements in targeted, mechanistic interventions for this population.

目的:一致的数据支持焦虑与进食障碍(EDs)之间存在关联,而进食障碍的理论模型表明,焦虑可能与进食障碍症状的病因和长期维持有关。然而,这些变量之间关系的方向性仍然不够明确,尤其是在治疗环境中:方法:我们使用双变量潜在变化评分模型,在强化治疗过程中以及 6 个月和 12 个月的随访中,对 ED 患者样本(样本数 = 548,93.2% 为女性,年龄 = 21.16,78.8% 为白人,79.6% 为非西班牙裔/拉丁裔)的焦虑和 ED 症状之间的纵向关系进行了探讨:探索每个变量独立变化的最佳拟合模型(即单变量模型)表明,ED 和焦虑症状的变化随着时间的推移而减少,但变化受个人在上一个时间点的症状严重程度的影响。探索这两个变量随时间变化之间关联的模型(即双变量潜在变化得分模型)表明,一个模型最适合焦虑和 ED 症状在一个时间点的变化与另一个时间点的变化相关联。具体来说,这些模型中的参数表明,焦虑水平越高,其后的性欲减退症状越明显,而性欲减退症状越明显,其后的焦虑减退症状越明显:我们的研究结果表明,焦虑和 ED 症状在强化治疗内外都有着错综复杂的关系。未来探索焦虑和 ED 症状在整个治疗过程中的实时联系的多模式研究对于扩展这项工作以及改进针对这一人群的有针对性的机制干预至关重要。
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引用次数: 0
A Mixed Method Systematic Review Into the Impact of ED Treatment in Autistic People and Those With High Autistic Traits 自闭症患者和高度自闭症患者 ED 治疗影响的混合方法系统回顾。
IF 4.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-14 DOI: 10.1002/eat.24311
Emy Nimbley, Helen Sharpe, Ellen Maloney, Karri Gillespie-Smith, Kate Tchanturia, Fiona Duffy

Objective

Our understanding of the impact of eating disorders (ED) treatment in Autistic people remains elusive. Research has begun to explore ED treatment outcomes and experiences in this population, however current understandings are poorly integrated. The current review therefore sought to explore the impact of ED treatment on Autistic people and those with higher Autistic traits.

Method

A convergent, segregated approach was used, independently evaluating quantitative then qualitative studies before integrating findings into a coherent narrative synthesis.

Results

Autistic people and people with higher Autistic traits report poorer experiences of treatment and may be at increased risk of inpatient admission and prolonged inpatient treatment, possibly explained by difficulties with treatment timeframes and a lack of autism-informed support. Both groups reported similar improvements in ED symptoms and BMI. Higher rates of psychosocial difficulties pre-and post-treatment were reported in those with higher Autistic traits, and emotion-focused interventions were felt to be particularly relevant to Autistic presentations of EDs. Concerns were reported as to how well aligned group-based programs and cognitive-based interventions are for Autistic individuals and those reporting higher Autistic traits.

Discussion

Future research in diagnosed autism samples is urgently needed to develop a more robust understanding of Autistic outcomes and experiences. Review findings demonstrate the need for increased understanding of ED presentations and the possible need for treatment adaptations, for Autistic people or those with higher Autistic traits.

目的:我们对饮食失调(ED)治疗对自闭症患者的影响仍然缺乏了解。研究已开始探索自闭症患者的饮食失调治疗结果和经验,但目前的认识还不够全面。因此,本综述旨在探讨饮食失调治疗对自闭症患者和自闭症特质较高者的影响:方法:采用聚合、分离的方法,先独立评估定量研究,然后再评估定性研究,最后将研究结果整合成一个连贯的叙述性综述:结果:自闭症患者和自闭症特质较强的患者的治疗体验较差,入院治疗和住院治疗时间延长的风险可能会增加,原因可能是治疗时间安排困难和缺乏自闭症知识支持。两组患者的 ED 症状和体重指数都有类似的改善。据报道,自闭症特征较高的患者在治疗前和治疗后出现社会心理障碍的比例较高,而以情绪为重点的干预措施被认为特别适用于自闭症表现的 ED。对于自闭症患者和自闭症特质较高的患者而言,以小组为基础的项目和以认知为基础的干预措施之间的一致性如何,也是一个值得关注的问题:讨论:未来迫切需要对已确诊的自闭症样本进行研究,以便更深入地了解自闭症的结果和经历。综述结果表明,有必要进一步了解自闭症患者或自闭症特质较高者的 ED 表现以及可能需要的治疗调整。
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引用次数: 0
Global and Regional Economic Burden of Eating Disorders: A Systematic Review and Critique of Methods 饮食失调症的全球和地区经济负担:系统回顾与方法批判》。
IF 4.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-14 DOI: 10.1002/eat.24302
Moin Ahmed, Md Deen Islam, Phillip Aouad, Jane Miskovic-Wheatley, Stephen Touyz, Sarah Maguire, Michelle Cunich

Objective

This systematic review aims to comprehensively examine up-to-date evidence on the economic burden of eating disorders (EDs), both globally and by region.

Methodology

A comprehensive search within five electronic databases, MEDLINE, Embase, CINAHL, PsycINFO, and EconLit, retrieved studies published from August 1, 2013, to June 30, 2024. Cost of illness (COI) studies, burden of disease, and other cost studies that reported costs in monetary values were included, and cost-effectiveness analysis studies were excluded. The quality of COI studies was assessed using Schnitzler's checklist. All cost estimates were converted into 2024 USD purchasing power parity (PPP). The PROSPERO registration number is CRD42022358136.

Findings

Twenty-six studies were identified for inclusion in this review, with 11 COI studies. The nationwide annual financial cost of EDs is estimated at PPP-USD 70.5 billion. Indirect costs contributed 70%–93% of total financial costs in the reviewed studies. Intangible costs (burden of disease) were estimated to be PPP-USD 355.6 billion. About half of the COI studies met 60% of the elements of Schnitzler's checklist, either completely or partly.

Discussion

The number of COI studies has more than doubled in the last 10 years. Findings can inform healthcare administrators/policymakers to understand the magnitude of this burden when setting healthcare priorities and allocating resources to maximize social welfare. However, there are variations in the methods (thus quality) and perspectives used to assess this economic burden. Findings suggest that there is potential for enhancing the methodological rigor of future research.

目的本系统性综述旨在全面研究全球和各地区饮食失调症(EDs)经济负担的最新证据:方法:在五个电子数据库(MEDLINE、Embase、CINAHL、PsycINFO 和 EconLit)中进行全面搜索,检索 2013 年 8 月 1 日至 2024 年 6 月 30 日期间发表的研究。纳入了疾病成本(COI)研究、疾病负担研究以及以货币价值报告成本的其他成本研究,但排除了成本效益分析研究。疾病成本(COI)研究的质量采用 Schnitzler 的核对表进行评估。所有成本估算值均转换为 2024 年美元购买力平价 (PPP)。PROSPERO 注册号为 CRD42022358136:本综述共纳入 26 项研究,其中有 11 项 COI 研究。据估计,全国每年的急诊室财务成本为 705 亿美元(购买力平价)。在所审查的研究中,间接成本占总财务成本的 70%-93% 。无形成本(疾病负担)估计为 3556 亿美元(购买力平价)。约有一半的 COI 研究完全或部分符合施尼茨勒清单中 60% 的要素:讨论:在过去 10 年中,COI 研究的数量增加了一倍多。研究结果可为医疗管理者/政策制定者提供信息,使其在确定医疗优先事项和分配资源以实现社会福利最大化时了解这一负担的严重程度。然而,用于评估这一经济负担的方法(即质量)和视角存在差异。研究结果表明,未来的研究有可能在方法上更加严谨。
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引用次数: 0
From Silos to Synergy: A Scoping Review of Team Approaches to Outpatient Eating Disorder Treatment 从孤立到协同:饮食失调症门诊治疗团队方法范围综述》。
IF 4.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-14 DOI: 10.1002/eat.24328
Megan Bray, Gabriella Heruc, Olivia R. L. Wright

Objective

This scoping review synthesizes the available evidence on team outpatient eating disorder treatment, focusing on team composition, reported health and service outcomes, and reported principles of Interprofessional Collaborative Practice (IPCP), a synergistic healthcare approach characterized by shared values and ethics, clear roles, communication, and teamwork.

Method

A comprehensive search was conducted across five databases, targeting studies published between January 2004 and August 2024 that discussed team–based outpatient eating disorder treatment. Peer-reviewed and gray literature were included if they detailed team composition, characteristics, dynamics, experiences, processes, or outcomes.

Results

Forty-five studies met the inclusion criteria; nearly half were case reports or lacked primary data. Treatment teams commonly comprised mental health professionals, dietitians, and medical practitioners. Clinical outcomes, such as body mass index and psychopathology, were the most frequently reported, while satisfaction and organizational outcomes were underrepresented. IPCP principles were inconsistently reported, with “Roles/Responsibilities” and “Communication” most frequently mentioned but often superficially addressed.

Discussion

The evidence base for team outpatient eating disorder treatment lacks rigor and depth. Future research should focus on refining the integration of roles across disciplines, developing comprehensive outcome measures for benchmarking, and applying IPCP principles more systematically.

目的:本概括性综述综合了有关团队门诊饮食失调症治疗的现有证据,重点关注团队组成、报告的健康和服务结果以及报告的专业间协作实践(IPCP)原则,IPCP 是一种以共同价值观和道德规范、明确角色、沟通和团队协作为特征的协同医疗保健方法:我们在五个数据库中进行了全面搜索,目标是 2004 年 1 月至 2024 年 8 月间发表的、讨论基于团队的门诊饮食失调治疗的研究。如果同行评审和灰色文献详细介绍了团队的组成、特点、动态、经验、过程或结果,则将其纳入其中:结果:45 项研究符合纳入标准;其中近一半为病例报告或缺乏原始数据。治疗团队通常由心理健康专业人员、营养师和医生组成。临床结果,如体重指数和心理病理学,是最常报道的内容,而满意度和组织结果则报道较少。对 IPCP 原则的报告并不一致,"角色/责任 "和 "沟通 "最常被提及,但往往只是敷衍了事:讨论:团队门诊饮食失调治疗的证据基础缺乏严谨性和深度。未来的研究应侧重于完善跨学科角色的整合、制定全面的结果衡量基准,以及更系统地应用 IPCP 原则。
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引用次数: 0
Elevating the Field of Eating Disorders Through Scholarship and Thoughtfulness: Honoring the Legacy of Dr. Michael Strober 通过学术和思想提升饮食失调领域:纪念迈克尔-斯特罗伯博士的遗产。
IF 4.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-14 DOI: 10.1002/eat.24327
Cynthia M. Bulik, Wesley R. Barnhart, Jamie Feusner, Rachael E. Flatt, Melissa A. Munn-Chernoff, Shelby N. Ortiz, Emily M. Pisetsky, Rachel Presskreischer, Laura M. Thornton, Zeynep Yilmaz

This Virtual Issue of the International Journal of Eating Disorders honors the legacy of the late Dr. Michael Strober in the eating disorders and child psychiatry fields. Having served as Editor-in-Chief of the International Journal of Eating Disorders from 1983 to 2012, Dr. Strober elevated the quality of science conducted in the eating disorders field. His frank feedback and encouraging words inspired many junior researchers to sharpen their work and to think deeply about their results. An incisive thinker, eloquent writer, and gifted clinician, Dr. Strober was a role model for psychologists in clinical leadership positions and demonstrated that it is indeed possible to be a highly effective all-rounder. In this issue, we present an annotated selection of Dr. Strober's publications in the journal over the past decades to illustrate the evolution of his thinking and the seeds of what have become major directions in the field, including fear conditioning and genetics. By presenting this collection of his work, we encourage all investigators to read broadly and deeply and to identify and acknowledge those incisive scholars who have built the foundation upon which our work today stands.

本期《国际进食障碍杂志》虚拟专刊旨在纪念已故的迈克尔-斯特罗伯博士在进食障碍和儿童精神病学领域留下的宝贵遗产。Strober 博士曾于 1983 年至 2012 年担任《国际进食障碍杂志》主编,提升了进食障碍领域的科学质量。他坦率的反馈意见和鼓励性的话语激励了许多初级研究人员,使他们的工作更加精益求精,并对自己的研究成果进行深入思考。Strober 博士思想敏锐、文笔雄辩,是一位才华横溢的临床医生,他是担任临床领导职务的心理学家的榜样,并证明了自己确实有可能成为一名高效的全能型人才。在本期杂志中,我们选取了斯特罗伯博士过去几十年来在杂志上发表的文章,并附上注释,以说明他的思想演变过程,以及该领域主要方向的萌芽,包括恐惧条件反射和遗传学。通过介绍他的这本著作集,我们鼓励所有研究人员广泛而深入地阅读,找出并感谢那些为我们今天的工作奠定基础的精辟学者。
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引用次数: 0
A Role for the Microbiota-Gut-Brain Axis in Avoidant/Restrictive Food Intake Disorder: A New Conceptual Model 微生物群-肠-脑轴在回避型/限制型食物摄入障碍中的作用:一个新的概念模型
IF 4.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-14 DOI: 10.1002/eat.24326
Elizabeth Schneider, Ricarda Schmidt, John F. Cryan, Anja Hilbert

Objective

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by a severely restrictive diet leading to significant physical and/or psychosocial sequelae. Largely owing to the phenotypic heterogeneity, the underlying pathophysiological mechanisms are relatively unknown. Recently, the communication between microorganisms within the gastrointestinal tract and the brain—the so-called microbiota-gut-brain axis—has been implicated in the pathophysiology of eating disorders. This Spotlight review sought to investigate and conceptualize the possible ways that the microbiota-gut-brain axis is involved in ARFID to drive future research in this area.

Method

By relating core symptoms of ARFID to gut microbiota and its signaling pathways to the brain, we evaluated how the gut microbiota is potentially involved in the pathophysiology of ARFID.

Results

We hypothesized that the restricted type and amount of food intake characteristic of ARFID diminishes gut microbial diversity, including beneficial bacteria and their metabolites capable of signaling to the brain, to modulate biopsychological pathways relevant to ARFID: homeostatic signaling, food reward, interoception, sensory sensitivity, disgust, perseveration, fear-based learning, and mood. Candidate signaling mechanisms include microbial-induced effects on inflammation, cortisol, and neurotransmitters such as dopamine and serotonin.

Discussion

Through reviewing the extant evidence, we conceptualized a new theoretical framework of ARFID with an emphasis on microbiota-gut-brain axis signaling to inform future research. Although more research is necessary to evaluate this theoretical model, the tentative evidence suggests that therapeutics specifically targeting the gut microbiota for the treatment of ARFID symptomatology warrants more investigation.

目的:回避型/限制型食物摄入障碍(ARFID)是一种以严重限制饮食为特征的进食障碍,会导致严重的身体和/或社会心理后遗症。主要由于表型的异质性,其潜在的病理生理机制相对未知。最近,胃肠道内微生物与大脑之间的交流--即所谓的微生物群-肠-脑轴--被认为与进食障碍的病理生理学有关。这篇焦点综述试图研究和概念化微生物群-肠-脑轴参与 ARFID 的可能方式,以推动该领域的未来研究:方法:通过将 ARFID 的核心症状与肠道微生物群及其与大脑的信号通路联系起来,我们评估了肠道微生物群是如何潜在地参与 ARFID 的病理生理学的:我们假设,ARFID特有的食物摄入类型和数量限制会减少肠道微生物的多样性,包括有益细菌及其代谢产物,它们能够向大脑发出信号,从而调节与ARFID相关的生物心理通路:平衡信号、食物奖赏、互感、感觉敏感性、厌恶、持久性、基于恐惧的学习和情绪。候选信号机制包括微生物诱导的对炎症、皮质醇和神经递质(如多巴胺和血清素)的影响:通过审查现有证据,我们构思了一个新的 ARFID 理论框架,重点是微生物群-肠-脑轴信号传导,为今后的研究提供参考。尽管需要更多的研究来评估这一理论模型,但初步证据表明,专门针对肠道微生物群治疗 ARFID 症状的疗法值得进一步研究。
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引用次数: 0
Investigating the Presence of Autistic Traits and Prevalence of Autism Spectrum Disorder Symptoms in Anorexia Nervosa: A Systematic Review and Meta-Analysis 调查神经性厌食症中自闭症特征的存在和自闭症谱系障碍症状的发生率:系统回顾与元分析》。
IF 4.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-12 DOI: 10.1002/eat.24307
Ipek Inal-Kaleli, Nurhak Dogan, Sezen Kose, Emre Bora

Objective

The present meta-analysis aims to assess whether individuals with anorexia nervosa (AN) demonstrate elevated autistic traits, to explore potential associations between autistic traits and eating disorder symptoms; as well as to estimate the prevalence of a positive screen for autism spectrum disorder (ASD) assessed via Autism Diagnostic Observation Schedule (ADOS), in AN.

Method

A systematic literature search was conducted in PsycINFO, MEDLINE, and Web of Science in August 2023 and later updated in April 2024 to identify relevant studies. Twenty-two studies with 1172 AN patients and 2747 healthy controls (HCs) met the inclusion criteria.

Results

There was a significant difference between AN and HC groups in autistic traits (g = 0.88, CI = 0.65–1.12), and a significant but modest correlation was found between autistic traits and severity of eating disorder symptoms (r = 0.28, CI = 0.11–0.44). Proportion meta-analysis indicated that 29% (CI = 0.19–0.38) of children and adults scored above the cut-off for ASD.

Discussion

The current findings suggest that AN frequently overlaps with both autistic traits and autistic symptomatology. Therefore, it is essential to evaluate autism and autistic traits in individuals with AN to tailor individualized treatment plans.

研究目的本荟萃分析旨在评估神经性厌食症(AN)患者是否表现出较高的自闭症特质,探讨自闭症特质与进食障碍症状之间的潜在关联;以及估计通过自闭症诊断观察表(ADOS)评估的自闭症谱系障碍(ASD)阳性筛查在AN患者中的患病率:于 2023 年 8 月在 PsycINFO、MEDLINE 和 Web of Science 中进行了系统性文献检索,并于 2024 年 4 月进行了更新,以确定相关研究。共有22项研究符合纳入标准,涉及1172名AN患者和2747名健康对照者(HCs):自闭症患者和健康对照组在自闭症特质方面存在明显差异(g = 0.88,CI = 0.65-1.12),自闭症特质与进食障碍症状严重程度之间存在显著但适度的相关性(r = 0.28,CI = 0.11-0.44)。比例荟萃分析表明,29%(CI = 0.19-0.38)的儿童和成人的得分高于自闭症的临界值:讨论:目前的研究结果表明,自闭症常常与自闭症特征和自闭症症状重叠。因此,有必要对自闭症患者的自闭症和自闭症特征进行评估,以制定个性化的治疗方案。
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引用次数: 0
Engagement in Intermittent Fasting is Prospectively Associated With Higher Body Mass Index, Higher Eating Disorder Psychopathology, and Lower Intuitive Eating in Chinese Adults 间歇性禁食与中国成年人较高的体重指数、较高的进食障碍病理心理和较低的直觉进食有关。
IF 4.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-12 DOI: 10.1002/eat.24322
Jinbo He, Xi Chen, Tianxiang Cui, Yueyang Xiao, Wesley R. Barnhart, Yitong Wang, Shouhe Yi, Jason M. Nagata

Objective

This study examined cross-sectional and longitudinal associations of intermittent fasting (IF) engagement with body mass index (BMI), both thinness-oriented and muscularity-oriented eating disorder (ED) psychopathology, eating-related psychosocial impairment, and intuitive eating.

Method

Using a longitudinal design, 491 Chinese adults (M age = 30.33 years, SD = 7.89) provided data regarding BMI, IF status, and eating variables at baseline (T1) and 8-month (T2) follow-up. One-way ANOVA was used to explore cross-sectional associations between IF engagement at T1 and study variables (i.e., BMI and eating variables) at T1. Cross-lagged regression analyses were used to examine the longitudinal associations between IF engagement at T1 and study variables at T2, after adjusting for covariates and study variables at T1.

Results

Cross-sectionally, compared with participants who never engaged in IF at T1, those with current or past engagement in IF at T1 exhibited significantly higher BMI, ED psychopathology, eating-related psychosocial impairment, and lower intuitive eating at T1. Longitudinally, relative to never engagement in IF at T1, both current and past engagement in IF at T1 were associated with higher ED psychopathology and greater eating-related psychosocial impairment at T2. Also, relative to never engagement in IF at T1, past engagement in IF at T1 was associated with higher BMI at T2 and lower unconditional permission to eat as a facet of intuitive eating at T2.

Discussion

The findings challenge the perception of IF as an effective approach for weight loss and also suggest IF might have enduring adverse impacts on eating behaviors, similar to traditional forms of dieting.

研究目的本研究探讨了间歇性禁食(IF)与体重指数(BMI)、以瘦为导向和以肌肉为导向的进食障碍(ED)心理病理学、与进食相关的社会心理障碍以及直觉进食之间的横向和纵向关联:采用纵向设计,491 名中国成年人(年龄 = 30.33 岁,SD = 7.89)在基线(T1)和 8 个月(T2)随访中提供了有关体重指数、IF 状态和饮食变量的数据。研究人员采用单因素方差分析来探究 IF 参与度(T1)与研究变量(即体重指数和饮食变量)(T1)之间的横截面关联。在对T1时的协变量和研究变量进行调整后,采用交叉滞后回归分析来研究T1时参与综合框架与T2时研究变量之间的纵向关联:横截面上,与在第一阶段从未参与过食物综合疗法的参与者相比,在第一阶段目前或过去参与过食物综合疗法的参与者在第一阶段表现出明显较高的体重指数(BMI)、ED 心理病理学、与饮食相关的心理社会损伤以及较低的直觉饮食水平。纵向来看,相对于在第一阶段从未接触过 IF 的人,在第一阶段目前和过去接触过 IF 的人在第二阶段都表现出更高的 ED 心理病理学和更大的与饮食相关的社会心理障碍。此外,相对于在第一阶段从未接触过 IF 的人,在第一阶段曾经接触过 IF 的人在第二阶段与较高的体重指数(BMI)和较低的无条件允许进食(作为直觉进食的一个方面)相关:讨论:这些研究结果对将 IF 视为有效减肥方法的看法提出了质疑,同时也表明 IF 可能会对饮食行为产生持久的不良影响,这与传统的节食形式类似。
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引用次数: 0
Predictors of Treatment Outcome in Persons With Anorexia Nervosa: On the Practice of Regressing Body Mass Index at the End of Treatment on Body Mass Index at Baseline 神经性厌食症患者治疗结果的预测因素:将治疗结束时的体重指数与基线时的体重指数进行回归的做法。
IF 4.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-12 DOI: 10.1002/eat.24324
Adrian Meule, David R. Kolar, Ulrich Voderholzer

Objective

It is often stated that a higher body mass index (BMI) at the beginning of treatment predicts a better weight outcome at the end of treatment in persons with anorexia nervosa (AN). However, this interpretation is based on the between-persons relationship of BMI at the two measurements, which primarily reflects the fact that the rank-ordering of persons according to their BMI is quite stable over time. In contrast, a lower BMI at baseline is related to a larger BMI change, which primarily reflects the fact that the variance of BMI at the end of treatment is larger than that at baseline. This study aimed to demonstrate these relationships empirically and caution against interpreting BMI at baseline as a predictor of BMI at discharge or BMI change.

Method

Changes of BMI from admission to discharge were analyzed based on 4863 persons with AN (97% female) who received inpatient treatment between 2015 and 2024.

Results

BMI at admission was positively related to BMI at discharge (r = 0.55) but negatively related to BMI change from admission to discharge (r = −0.39).

Discussion

While it is true that a higher BMI at baseline is associated with a higher BMI at the end of treatment, a lower BMI at baseline is actually related to a larger weight gain during treatment. Yet, concluding that the treatment is more effective for patients with low or high BMI at baseline would be incorrect in either case, as the independent and dependent variables are the same variables measured at different time points.

目的:人们常说,治疗初期体重指数(BMI)越高,治疗结束时神经性厌食症(AN)患者的体重结果越好。然而,这种解释是基于两次测量时体重指数的人际关系,这主要反映了一个事实,即随着时间的推移,根据体重指数对人的排序是相当稳定的。与此相反,基线时较低的体重指数与较大的体重指数变化相关,这主要反映了治疗结束时的体重指数方差大于基线时的体重指数方差这一事实。本研究旨在通过实证证明这些关系,并告诫人们不要将基线时的体重指数解释为出院时体重指数或体重指数变化的预测因素:结果:入院时的体重指数与出院时的体重指数呈正相关:入院时的体重指数与出院时的体重指数呈正相关(r = 0.55),但与入院至出院时的体重指数变化呈负相关(r = -0.39):讨论:虽然基线体重指数越高,治疗结束时的体重指数就越高,但基线体重指数越低,治疗期间体重增加的幅度就越大。然而,由于自变量和因变量是在不同时间点测量的相同变量,因此得出基线体重指数较低或较高的患者治疗效果更好的结论都是不正确的。
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引用次数: 0
Issue Information: Editorial Board & Table of Contents 期刊信息:编辑委员会和目录
IF 4.7 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-11-12 DOI: 10.1002/eat.24325
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引用次数: 0
期刊
International Journal of Eating Disorders
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