Wilson G Terence, Grilo Carlos M, Vitousek Kelly M
Rutgers Eating Disorders Clinic, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA.
Am Psychol. 2007 Apr;62(3):199-216. doi: 10.1037/0003-066X.62.3.199.
Significant progress has been achieved in the development and evaluation of evidence-based psychological treatments for eating disorders over the past 25 years. Cognitive behavioral therapy is currently the treatment of choice for bulimia nervosa and binge-eating disorder, and existing evidence supports the use of a specific form of family therapy for adolescents with anorexia nervosa. Important challenges remain. Even the most effective interventions for bulimia nervosa and binge-eating disorder fail to help a substantial number of patients. A priority must be the extension and adaptation of these treatments to a broader range of eating disorders (eating disorder not otherwise specified), to adolescents, who have been largely overlooked in clinical research, and to chronic, treatment-resistant cases of anorexia nervosa. The article highlights current conceptual and clinical innovations designed to improve on existing therapeutic efficacy. The problems of increasing the dissemination of evidence-based treatments that are unavailable in most clinical service settings are discussed.
在过去25年里,饮食失调循证心理治疗的开发和评估取得了重大进展。认知行为疗法目前是神经性贪食症和暴饮暴食症的首选治疗方法,现有证据支持对神经性厌食症青少年使用特定形式的家庭治疗。但重要挑战依然存在。即使是针对神经性贪食症和暴饮暴食症最有效的干预措施,也无法帮助大量患者。当务之急是将这些治疗方法扩展并适用于更广泛的饮食失调类型(未另行规定的饮食失调)、青少年(他们在临床研究中基本被忽视)以及神经性厌食症的慢性、难治性病例。本文重点介绍了旨在提高现有治疗效果的当前概念和临床创新。还讨论了增加在大多数临床服务环境中无法获得的循证治疗方法传播的问题。