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饮食失调治疗的当前及新出现的方向。

Current and emerging directions in the treatment of eating disorders.

作者信息

Brown Tiffany A, Keel Pamela K

机构信息

Department of Psychology, Florida State University, Tallahassee, FL.

出版信息

Subst Abuse. 2012;6:33-61. doi: 10.4137/SART.S7864. Epub 2012 Mar 29.

Abstract

Eating disorders are a significant source of psychiatric morbidity in young women and demonstrate high comorbidity with mood, anxiety, and substance use disorders. Thus, clinicians may encounter eating disorders in the context of treating other conditions. This review summarizes the efficacy of current and emerging treatments for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Treatment trials were identified using electronic and manual searches and by reviewing abstracts from conference proceedings. Family based therapy has demonstrated superiority for adolescents with AN but no treatment has established superiority for adults. For BN, both 60 mg fluoxetine and cognitive behavioral therapy (CBT) have well-established efficacy. For BED, selective serotonin reuptake inhibitors, CBT, and interpersonal psychotherapy have demonstrated efficacy. Emerging directions for AN include investigation of the antipsychotic olanzapine and several novel psychosocial treatments. Future directions for BN and BED include increasing CBT disseminability, targeting affect regulation, and individualized stepped-care approaches.

摘要

饮食失调是年轻女性精神疾病的一个重要来源,并且与情绪、焦虑和物质使用障碍高度共病。因此,临床医生在治疗其他疾病时可能会遇到饮食失调问题。本综述总结了目前及新兴的神经性厌食症(AN)、神经性贪食症(BN)和暴饮暴食症(BED)治疗方法的疗效。通过电子检索、手工检索以及查阅会议论文摘要来确定治疗试验。基于家庭的治疗方法已证明对患有神经性厌食症的青少年具有优势,但尚无治疗方法对成年人显示出优势。对于神经性贪食症,60毫克氟西汀和认知行为疗法(CBT)均具有公认的疗效。对于暴饮暴食症,选择性5-羟色胺再摄取抑制剂、认知行为疗法和人际心理治疗已证明有效。神经性厌食症的新兴研究方向包括对抗精神病药物奥氮平和几种新型心理社会治疗方法的研究。神经性贪食症和暴饮暴食症未来的研究方向包括提高认知行为疗法的可传播性、针对情感调节以及个性化的逐步护理方法。

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