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饮食失调中的药物治疗和心理治疗:研究与实践之间存在差距吗?

Medication and psychotherapy in eating disorders: is there a gap between research and practice?

机构信息

Isis Education Centre, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK.

出版信息

J Eat Disord. 2015 Dec 1;3:45. doi: 10.1186/s40337-015-0080-0. eCollection 2015.

Abstract

BACKGROUND

Little research has investigated the use of evidence-based guidelines by eating disorder (ED) therapists, or prescribing of psychotropic medication. Moreover, people with EDs have rarely been surveyed on these topics, and their clinical and demographic features have not been presented. This study investigated perception of psychotherapy, psychotropic medication and the clinical characteristics of a community sample of people with EDs.

METHOD

An online survey methodology was used to recruit 253 people with eating disorders in the community. Where feasible, comparisons were made between four types of eating disorder, anorexia nervosa, bulimia nervosa, and two types of atypical or 'sub-threshold' eating disorder.

RESULTS

Unlike medication, reported psychotherapy showed some congruence with evidence based and other guidance. Most participants were currently receiving either psychotherapy, medication or both, and most had a severe and chronic ED.

CONCLUSIONS

Findings are considered in light of use of evidence-based treatment for EDs, calls for greater dissemination of cognitive behaviour therapy (CBT); indications that much may be poor quality; and the importance of what treatments to offer those who are chronically and severely ill. Development of theory and novel treatments is considered a priority.

摘要

背景

很少有研究调查饮食失调(ED)治疗师使用循证指南或开精神药物的情况。此外,很少有关于这些主题的 ED 患者调查,也没有介绍他们的临床和人口统计学特征。本研究调查了社区样本中 ED 患者对心理治疗、精神药物的看法以及他们的临床特征。

方法

采用在线调查方法招募了 253 名社区饮食失调患者。在可行的情况下,对四种饮食失调症(神经性厌食症、神经性贪食症和两种非典型或“亚阈值”饮食失调症)进行了比较。

结果

与药物治疗不同,报告的心理治疗与循证和其他指南有一定的一致性。大多数参与者目前正在接受心理治疗、药物治疗或两者兼而有之,而且大多数人都患有严重和慢性的 ED。

结论

这些发现是根据 ED 的循证治疗的使用情况、对更广泛传播认知行为疗法(CBT)的呼吁、表明许多治疗质量可能较差的迹象,以及为那些患有慢性和严重疾病的人提供何种治疗的重要性来考虑的。理论和新型治疗方法的发展被认为是当务之急。

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