Khazaal Yasser, Fresard Emmanuelle, Rabia Sophie, Chatton Anne, Rothen Stephane, Pomini Valentino, Grasset François, Borgeat François, Zullino Daniele
Department of Psychiatry, University Hospital of Vaud, Lausanne, Switzerland.
Schizophr Res. 2007 Mar;91(1-3):169-77. doi: 10.1016/j.schres.2006.12.025. Epub 2007 Feb 15.
Overweight and obesity are common concerns in individuals with severe mental disorders. In particular, antipsychotic drugs (AP) frequently induce weight gain. This phenomenon lacks current management and no previous controlled studies seem to use cognitive therapy to modify eating and weight-related cognitions. Moreover, none of these studies considered binge eating or eating and weight-related cognitions as possible outcomes.
The main aim of this study is to assess the effectivity of cognitive and behavioural treatment (CBT) on eating and weight-related cognitions, binge eating symptomatology and weight loss in patients who reported weight gain during AP treatment.
A randomized controlled study (12-week CBT vs. Brief Nutritional Education) was carried out on 61 patients treated with an antipsychotic drug who reported weight gain following treatment. Binge eating symptomatology, eating and weight-related cognitions, as well as weight and body mass index were assessed before treatment, at 12 weeks and at 24 weeks.
The CBT group showed some improvement with respect to binge eating symptomatology and weight-related cognitions, whereas the control group did not. Weight loss occurred more progressively and was greater in the CBT group at 24 weeks.
The proposed CBT treatment is particularly interesting for patients suffering from weight gain associated with antipsychotic treatment.
超重和肥胖是重度精神障碍患者常见的问题。特别是,抗精神病药物(AP)经常会导致体重增加。目前针对这一现象缺乏有效管理,而且之前似乎没有对照研究使用认知疗法来改变与饮食和体重相关的认知。此外,这些研究均未将暴饮暴食或与饮食和体重相关的认知视为可能的结果。
本研究的主要目的是评估认知行为疗法(CBT)对在AP治疗期间体重增加的患者的饮食和体重相关认知、暴饮暴食症状及体重减轻的有效性。
对61名接受抗精神病药物治疗且治疗后体重增加的患者进行了一项随机对照研究(12周的CBT与简短营养教育对比)。在治疗前、12周和24周时评估暴饮暴食症状、与饮食和体重相关的认知,以及体重和体重指数。
CBT组在暴饮暴食症状和与体重相关的认知方面有一定改善,而对照组则没有。体重减轻在CBT组更为渐进,且在24周时更明显。
对于因抗精神病药物治疗导致体重增加的患者,所提出的CBT治疗尤其值得关注。