Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA 19104-3309, USA.
Psychiatr Clin North Am. 2011 Dec;34(4):785-96. doi: 10.1016/j.psc.2011.08.002. Epub 2011 Sep 29.
Although treatment research for NES remains limited, several options are available for patients whose symptoms require clinical attention. Pharmacotherapy has received the most empirical support of the proposed treatments. Controlled trials are needed to confirm the initial results from pilot studies with CBT, behavioral therapy, and phototherapy, and an extended controlled trial of progressive muscle relaxation would be useful. In their comprehensive review of the field, Striegel-Moore and colleagues have questioned the clinical utility of NES as a diagnostic entity and stress the very limited nature of treatment studies to date. Research in this field has to provide a systematic examination of the approaches described here, as well as others yet to be identified. This pursuit seems warranted given that persons suffering with the cluster of symptoms identified as NES are approaching health care providers for relief and are often frustrated by the lack of recognition of this syndrome. Future studies should test a wider variety of medications that would target serotonin or the circadian timing of eating. Additionally, trials comparing and combining medication treatments and CBT (or progressive muscle relaxation alone) would also be useful in addressing which treatment should be used as a first line treatment. With NES being considered for inclusion as a Feeding and Eating Condition Not Elsewhere Classified (FEC-NEC) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, it is likely that more clinical attention and studies will address these important issues in the coming years.
虽然针对非节食性暴食障碍的治疗研究仍然有限,但对于那些症状需要临床关注的患者,有几种选择。药物治疗是已提出的治疗方法中得到最多实证支持的。需要进行对照试验来证实从认知行为治疗、行为治疗和光照治疗的初步试验中得出的初始结果,并且进行渐进性肌肉松弛的扩展对照试验也将是有用的。在对该领域的全面综述中,Striegel-Moore 及其同事对将非节食性暴食障碍作为一种诊断实体的临床实用性提出了质疑,并强调迄今为止治疗研究的性质非常有限。该领域的研究必须对这里描述的方法以及其他尚未确定的方法进行系统检查。鉴于患有被确定为非节食性暴食障碍的一系列症状的人正在寻求医疗保健提供者的帮助以获得缓解,并且经常因缺乏对这种综合征的认识而感到沮丧,因此这种追求似乎是合理的。未来的研究应该测试更多针对血清素或进食的昼夜节律的药物。此外,比较和结合药物治疗和认知行为治疗(或单独进行渐进性肌肉松弛)的试验也将有助于确定哪种治疗应作为一线治疗。由于非节食性暴食障碍被认为是《精神障碍诊断与统计手册(第五版)》中未在其他地方分类的进食和摄食障碍的一种,因此在未来几年中,可能会有更多的临床关注和研究来解决这些重要问题。