Hartmann A, Herzog T, Drinkmann A
Department of Psychotherapy and Psychosomatic Medicine, University of Freiburg, Germany.
J Psychosom Res. 1992 Feb;36(2):159-67. doi: 10.1016/0022-3999(92)90024-v.
The present paper assesses the state of the art of psychotherapy of bulimia nervosa. Five hundred and fifty publications available up to April 1990 were systematically screened. Included in subsequent analysis were all studies with samples of five or more bulimic patients which used operational diagnostic criteria, and reported results of binging and vomiting or other means of purging quantitatively. Only 18 independent studies with a total of 433 patients in 24 treatments and 61 patients in 6 control groups fulfilled these criteria. Therapy outcome across studies was assessed meta-analytically. Therapy process across studies was assessed through ratings of interventions used (behavioural, cognitive, educational, humanistic, psychodynamic techniques and symptom-, conflict-, and relationship-orientation), setting and dose parameters. Settings were out-patients only, mostly group or individual. Most studies were on short-term therapies and follow-ups. Stepwise regression analysis revealed no definite advantage of one setting or therapeutic approach over another. Thirty-six per cent of variance was explained by the number of treatment sessions in combination with relationship orientation.
本文评估了神经性贪食症心理治疗的现状。系统筛选了截至1990年4月的550篇出版物。后续分析纳入了所有样本量为5名或更多贪食症患者的研究，这些研究使用了操作性诊断标准，并定量报告了暴饮暴食、呕吐或其他清除方式的结果。只有18项独立研究符合这些标准，共有433名患者接受了24种治疗，61名患者作为6个对照组。通过荟萃分析评估各项研究的治疗结果。通过对所使用的干预措施（行为、认知、教育、人本主义、心理动力学技术以及症状、冲突和关系导向）、治疗环境和剂量参数的评分来评估各项研究的治疗过程。治疗环境仅为门诊，大多是团体治疗或个体治疗。大多数研究针对短期治疗和随访。逐步回归分析显示，一种治疗环境或治疗方法相对于另一种并没有明确优势。36%的方差由治疗疗程数与关系导向共同解释。
