Fichter M M, Leibl K, Rief W, Brunner E, Schmidt-Auberger S, Engel R R
Klinik Roseneck, Hospital for Behavioral Medicine, Prien, Germany.
Pharmacopsychiatry. 1991 Jan;24(1):1-7. doi: 10.1055/s-2007-1014424.
In a double-blind trial 40 patients with bulimia nervosa according to DSM III-R criteria were randomly assigned either to a 60 mg fluoxetine group or to a placebo control group. Fluoxetine or placebo was given over a period of 35 days. Parallel to the drug trial, patients participated in an intensive inpatient behavioral psychotherapy program. There were no dropouts at all in the study. Fluoxetine was well tolerated and had only minor adverse effects. In self-ratings and expert ratings concerning attitudes towards eating, eating behavior, and general psychopathology, significant improvements over time were observed in both groups. Using analysis of variance (ANOVA), however, there were no statistically significant "group by time" differences. Results show that the intensive inpatient-care and psychotherapy program was highly effective in changing eating behavior and attitudes as well as general psychopathology. Fluoxetine showed a significant reduction in body weight, especially during the first three weeks of fluoxetine treatment. It was not possible to demonstrate a statistically significant improvement in eating attitudes, eating behavior, and general psychopathology beyond that elicited by intensive inpatient psychotherapy and general inpatient care. These results can possibly be explained by the existence of a "ceiling effect".
在一项双盲试验中，根据《精神疾病诊断与统计手册》第三版修订版（DSM III-R）标准，40名神经性贪食症患者被随机分为60毫克氟西汀组或安慰剂对照组。氟西汀或安慰剂给药35天。与药物试验同时，患者参加了一个强化住院行为心理治疗项目。该研究中完全没有患者退出。氟西汀耐受性良好，只有轻微的不良反应。在关于饮食态度、饮食行为和一般精神病理学的自评和专家评分中，两组随时间推移均有显著改善。然而，使用方差分析（ANOVA），没有发现统计学上显著的“组×时间”差异。结果表明，强化住院护理和心理治疗项目在改变饮食行为、态度以及一般精神病理学方面非常有效。氟西汀使体重显著下降，尤其是在氟西汀治疗的前三周。除了强化住院心理治疗和一般住院护理所引发的改善之外，无法证明在饮食态度、饮食行为和一般精神病理学方面有统计学上显著的改善。这些结果可能可以用“天花板效应”的存在来解释。
