饮食失调症心理治疗的效果和预测因素:最新进展和未来方向。

IF 7.5 2区 医学 Q1 PSYCHIATRY Current Opinion in Psychiatry Pub Date : 2024-11-01 Epub Date: 2024-08-13 DOI:10.1097/YCO.0000000000000961
Alessio Maria Monteleone, Giovanni Abbate-Daga
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引用次数: 0

摘要

审查目的:心理治疗是饮食失调症多学科治疗方法的基石。本综述研究了有关饮食失调症心理疗法的有效性、预测因素和改变机制的最新证据,为临床医生和研究人员提供了路线图:基于家庭的治疗(FBT)对患有神经性厌食症和神经性贪食症的青少年有效。在成人厌食症患者中,基于证据的厌食症心理疗法与常规疗法(TAU)相比没有优越性的证据。认知行为疗法(CBT)是推荐用于神经性贪食症和暴饮暴食症(BED)成人患者的首选心理疗法。有证据表明,自助干预对非体重过轻的进食障碍患者有效。早期症状改善和青少年年龄预示着更有利的结果。小结:可以建议对进食障碍采用循证心理疗法,但需要后续数据。除了神经性厌食症、神经性贪食症和BED之外,还没有证据表明心理疗法对其他饮食失调症有效。新型(如 "第三波")心理疗法、治疗方式(如互联网)和辅助干预(如虚拟现实)的有效性有待进一步探讨。建议对康复进行更广泛的定义,包括行为、身体和心理标准。对变化的预测因素和机制的研究还不够:需要进行定量和定性研究,以促进更有针对性和个性化的心理治疗干预。
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Effectiveness and predictors of psychotherapy in eating disorders: state-of-the-art and future directions.

Purpose of review: Psychotherapy is the cornerstone of the multidisciplinary treatment approach for eating disorders. This review examines recent evidence regarding effectiveness, predictors, and mechanisms of change of psychotherapy in eating disorders, providing a road map for clinicians and researchers.

Recent findings: Family-based treatments (FBT) are effective in adolescents with anorexia nervosa and bulimia nervosa. Evidence-based psychotherapies for anorexia nervosa have no evidence of superiority compared with treatment as usual (TAU) in adults with anorexia nervosa. Cognitive-behavioural therapy (CBT) is the first-choice psychotherapy recommended for adults with bulimia nervosa and binge-eating disorder (BED). Self-help interventions have some evidence of effectiveness in nonunderweight individuals with eating disorders. Early symptom improvement and adolescent age predict more favourable outcomes.

Summary: Evidence-based psychotherapies can be suggested for eating disorders, although follow-up data are needed. Beyond anorexia nervosa, bulimia nervosa, and BED, there is no evidence of psychotherapy effectiveness in other eating disorders. The effectiveness of novel (e.g. 'third-wave') psychotherapies, treatment delivery modality (e.g. internet-delivered), and adjunctive interventions (e.g. virtual reality) needs to be further explored. A broader definition of recovery is recommended, including behavioural, physical, and psychological criteria. Predictors and mechanisms of changes have not been studied enough: quantitative and qualitative studies are needed to promote more tailored and individualized psychotherapy interventions.

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来源期刊
Current Opinion in Psychiatry
Current Opinion in Psychiatry 医学-精神病学
CiteScore
12.20
自引率
1.40%
发文量
76
审稿时长
6-12 weeks
期刊介绍: Current Opinion in Psychiatry is an easy-to-digest bimonthly journal covering the most interesting and important advances in the field of psychiatry. Eight sections on mental health disorders including schizophrenia, neurodevelopmental disorders and eating disorders, are presented alongside five area-specific sections, offering an expert evaluation on the most exciting developments in the field.
期刊最新文献
Early intervention for eating disorders. Effectiveness and predictors of psychotherapy in eating disorders: state-of-the-art and future directions. Systematic review of the epidemiology of eating disorders in the Arab world. Eating disorders: etiology, risk factors, and suggestions for prevention. Treatment escalation for people with anorexia nervosa: setting, therapies and nutritional interventions.
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