Asch M, Esteves J, De Hautecloque D, Bargiacchi A, Le Heuzey M-F, Mouren M-C, Doyen C
Service de psychiatrie de l'enfant et de l'adolescent, hôpital Robert-Debré, 48, boulevard Serrurier, 75019 Paris, France.
Service de psychiatrie de l'enfant et de l'adolescent, hôpital Robert-Debré, 48, boulevard Serrurier, 75019 Paris, France.
Encephale. 2014 Jun;40(3):240-6. doi: 10.1016/j.encep.2013.10.004. Epub 2014 Mar 14.
Cognitive remediation therapy (CRT) seems to be increasingly interesting in the treatment of anorexia nervosa for adult patients. We attempted to apply this support to a group of young inpatients, initially to assess its feasibility and acceptability, and then to improve its content for therapeutic application and future research.
Ten 12- to 17-year-old inpatients with primary DSM-IV diagnosis of anorexia nervosa participated in a 10-week intervention program with a one-hour group session of CRT per week. All 10 patients were assessed before the intervention and those who completed the 10 sessions were assessed after. Assessment included a clinical examination by a psychiatrist, a battery of clinical inventories, and set-shifting tests. Moreover, each patient wrote a letter providing feedback on the intervention for subsequent analysis.
Only two patients completed all 10 sessions, the other eight who were discharged from the hospital in the meantime could not attend the sessions for practical reasons. After the 10 sessions, an improvement in BMI and in measured levels of some psychopathological symptoms was observed in our two patients. Most neuropsychological task performances were improved after cognitive remediation. Feedback from the 10 patients was generally positive.
This preliminary investigation suggests that cognitive remediation therapy is acceptable and feasible in this population. Replication of these findings requires a larger sample, improvement of the trial design, more sensitive measures, and another training format to avoid loss of so many participants.
认知康复治疗(CRT)在成年神经性厌食症患者的治疗中似乎越来越受到关注。我们试图将这种治疗方法应用于一组年轻住院患者,首先评估其可行性和可接受性,然后改进其治疗应用内容以及未来的研究。
10名年龄在12至17岁、最初被诊断为原发性DSM-IV神经性厌食症的住院患者参加了一个为期10周的干预项目,每周进行一次为时1小时的CRT小组治疗。所有10名患者在干预前接受评估,完成10次治疗的患者在结束后接受评估。评估包括由精神科医生进行的临床检查、一系列临床量表以及转换任务测试。此外,每位患者都写了一封信,对干预措施提供反馈以便后续分析。
只有两名患者完成了全部10次治疗,另外8名在此期间出院的患者因实际原因未能参加治疗。在10次治疗后,我们的两名患者的体重指数(BMI)以及一些精神病理症状的测量水平有所改善。认知康复治疗后,大多数神经心理学任务表现都有所提高。10名患者的反馈总体上是积极的。
这项初步调查表明,认知康复治疗在该人群中是可接受且可行的。要重复这些研究结果,需要更大的样本量、改进试验设计、采用更敏感的测量方法以及另一种培训形式,以避免如此多的参与者流失。