Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Int J Eat Disord. 2013 Sep;46(6):567-75. doi: 10.1002/eat.22134. Epub 2013 Apr 29.
There are limited data supporting specific treatments for adults with anorexia nervosa (AN). Randomized clinical trials (RCTs) for adults with AN are characterized by high attrition limiting the feasibility of conducting and interpreting existing studies. High dropout rates may be related to the inflexible and obsessional cognitive style of patients with AN. This study evaluated the feasibility of using cognitive remediation therapy (CRT) to reduce attrition in RCTs for AN.
Forty-six participants (mean age of 22.7 years and mean duration of AN of 6.4 years) were randomized to receive eight sessions of either CRT or cognitive behavioral therapy (CBT) over 2 months followed by 16 sessions of CBT for 4 months.
During the 2-month CRT vs. CBT treatment, rates of attrition were lower in CRT (13%) compared with that of CBT (33%). There were greater improvements in cognitive inefficiencies in the CRT compared with that of the CBT group at the end of 2 months. There were no differences in other outcomes.
These results suggest that CRT is acceptable and feasible for use in RCTs for outpatient treatment of AN. CRT may reduce attrition in the short term. Adequately powered future studies are needed to examine CRT as an outpatient treatment for AN.
针对厌食症（AN）成人患者，目前仅有少量支持特定治疗方法的数据。针对成人 AN 的随机临床试验（RCT）的特点是高脱落率，限制了现有研究的可行性和解释。高脱落率可能与 AN 患者僵化和强迫症的认知方式有关。本研究评估了认知矫正治疗（CRT）在减少 AN RCT 脱落率方面的可行性。
46 名参与者（平均年龄 22.7 岁，AN 病程平均 6.4 年）被随机分为 CRT 组或认知行为疗法（CBT）组，分别接受 8 次或 2 个月的 CRT 或 CBT 治疗，随后进行 4 个月、16 次的 CBT 治疗。
在 2 个月的 CRT 与 CBT 治疗期间，CRT 组（13%）的脱落率明显低于 CBT 组（33%）。在 2 个月结束时，CRT 组的认知效率改善情况明显优于 CBT 组。两组在其他结果方面无差异。
这些结果表明，CRT 可接受且适用于 AN 门诊治疗的 RCT。CRT 可能会在短期内降低脱落率。需要进行足够有力的未来研究，以检验 CRT 作为 AN 门诊治疗的方法。
