Olmsted Marion P, MacDonald Danielle E, McFarlane Traci, Trottier Kathryn, Colton Patricia
Department of Psychiatry, University Health Network, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
Int J Eat Disord. 2015 Apr;48(3):337-40. doi: 10.1002/eat.22380. Epub 2014 Dec 26.
Relapse remains a significant concern in bulimia nervosa, with some patients relapsing within months of treatment completion. The purpose of the study was to identify predictors of relapse within the first 6 months following treatment.
The 116 participants were bingeing and/or vomiting ≥ 8 times per month before day hospital (DH), and had ≤ 2 episodes per month in the last month of DH and the first month after DH. Rapid relapse was defined as ≥ 8 episodes per month for 3 months starting within 6 months.
The rate of rapid relapse was 27.6%. Patients who relapsed soon after DH had higher frequencies of bingeing and vomiting before treatment, engaged in less body avoidance before treatment and were more likely to be slow responders to treatment. Weight and shape concerns and body checking were not significant predictors.
More frequent bulimic symptoms accompanied by less body avoidance may indicate an entrenchment in the illness which in turn augurs a labored and transient response to DH treatment that is difficult to sustain after intensive treatment ends.
在神经性贪食症中，复发仍是一个重大问题，一些患者在治疗结束后的数月内就会复发。本研究的目的是确定治疗后前6个月内复发的预测因素。
116名参与者在日间医院（DH）治疗前每月暴饮暴食和/或呕吐≥8次，在DH治疗的最后一个月及DH治疗后的第一个月每月发作≤2次。快速复发定义为在6个月内开始的3个月中每月发作≥8次。
快速复发率为27.6%。在DH治疗后不久复发的患者在治疗前暴饮暴食和呕吐的频率更高，在治疗前较少回避身体，并且更有可能是治疗反应缓慢者。对体重和体型的关注以及身体检查并不是显著的预测因素。
更频繁的贪食症状伴随着较少的身体回避可能表明病情根深蒂固，这反过来预示着对DH治疗的反应艰难且短暂，在强化治疗结束后难以维持。
