Bergh Cecilia, Brodin Ulf, Lindberg Greger, Södersten Per
Section of Applied Neuroendocrinology and Center for Eating Disorders, Karolinska Institutet, Novum, S-141 57 Huddinge, Sweden.
Proc Natl Acad Sci U S A. 2002 Jul 9;99(14):9486-91. doi: 10.1073/pnas.142284799. Epub 2002 Jun 24.
Evidence for the effectiveness of existing treatments of patients with eating disorders is weak. Here we describe and evaluate a method of treatment in a randomized controlled trial. Sixteen patients, randomly selected out of a group composed of 19 patients with anorexia nervosa and 13 with bulimia nervosa, were trained to eat and recognize satiety by using computer support. They rested in a warm room after eating, and their physical activity was restricted. The patients in the control group (n = 16) received no treatment. Remission was defined by normal body weight (anorexia), cessation of binge eating and purging (bulimia), a normal psychiatric profile, normal laboratory test values, normal eating behavior, and resumption of social activities. Fourteen patients went into remission after a median of 14.4 months (range 4.9-26.5) of treatment, but only one patient went into remission while waiting for treatment (P = 0.0057). Relapse is considered a major problem in patients who have been treated to remission. We therefore report results on a total of 168 patients who have entered our treatment program. The estimated rate of remission was 75%, and estimated time to remission was 14.7 months (quartile range 9.6 > or = 32). Six patients (7%) of 83 who were treated to remission relapsed, but the others (93%) have remained in remission for 12 months (quartile range 6-36). Because the risk of relapse is maximal in the first year after remission, we suggest that most patients treated with this method recover.
现有饮食失调症治疗方法有效性的证据不足。在此，我们在一项随机对照试验中描述并评估一种治疗方法。从19名神经性厌食症患者和13名神经性贪食症患者组成的群体中随机选出16名患者，通过计算机辅助训练他们进食并识别饱腹感。进食后他们在温暖的房间休息，且身体活动受到限制。对照组（n = 16）的患者未接受治疗。缓解的定义为体重正常（厌食症）、停止暴饮暴食和清除行为（贪食症）、精神状况正常、实验室检查值正常、饮食行为正常以及恢复社交活动。治疗中位数14.4个月（范围4.9 - 26.5）后，14名患者病情缓解，但只有1名患者在等待治疗期间病情缓解（P = 0.0057）。复发被认为是病情缓解后接受治疗患者的一个主要问题。因此，我们报告了总共168名进入我们治疗项目患者的结果。估计缓解率为75%，估计缓解时间为14.7个月（四分位间距9.6≥32）。83名病情缓解的患者中有6名（7%）复发，但其他患者（93%）病情缓解持续了12个月（四分位间距6 - 36）。由于复发风险在缓解后的第一年最高，我们认为大多数采用这种方法治疗的患者能够康复。
