Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Germany.
Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Germany.
Psychiatry Res. 2016 Oct 30;244:45-50. doi: 10.1016/j.psychres.2016.07.002. Epub 2016 Jul 8.
This study aimed to determine predictors of BMI and recovery for outpatients with anorexia nervosa (AN). Patients were participants of the ANTOP (Anorexia Nervosa Treatment of Out-Patients) trial and randomized to focal psychodynamic therapy (FPT), enhanced cognitive behavior therapy (CBT-E), or optimized treatment as usual (TAU-O). N=169 patients participated in the one-year follow-up (T4). Outcomes were the BMI and global outcome (recovery/partial syndrome/full syndrome) at T4. We examined the following baseline variables as possible predictors: age, BMI, duration of illness, subtype of AN, various axis I diagnoses, quality of life, self-esteem, and psychological characteristics relevant to AN. Linear and logistic regression analyses were conducted to identify the predictors of the BMI and global outcome. The strongest positive predictor for BMI and recovery at T4 was a higher baseline BMI of the patients. Negative predictors for BMI and recovery were a duration of illness >6 years and a lifetime depression diagnosis at baseline. Additionally, higher bodily pain was significantly associated with a lower BMI and self-esteem was a positive predictor for recovery at T4. A higher baseline BMI and shorter illness duration led to a better outcome. Further research is necessary to investigate whether or not AN patients with lifetime depression, higher bodily pain, and lower self-esteem may benefit from specific treatment approaches.
本研究旨在确定神经性厌食症(AN)门诊患者体重指数(BMI)和康复的预测因素。患者为 ANTOP(AN 门诊治疗)试验的参与者,并随机分为焦点心理动力学治疗(FPT)、强化认知行为治疗(CBT-E)或优化常规治疗(TAU-O)。共有 169 名患者参加了为期一年的随访(T4)。结局是 T4 时的 BMI 和总体结局(康复/部分综合征/完全综合征)。我们检查了以下基线变量作为可能的预测因素:年龄、BMI、疾病持续时间、AN 亚型、各种轴 I 诊断、生活质量、自尊和与 AN 相关的心理特征。进行线性和逻辑回归分析以确定 BMI 和总体结局的预测因素。患者基线 BMI 较高是 T4 时 BMI 和康复的最强正预测因素。BMI 和康复的负预测因素是疾病持续时间>6 年和基线时有终生抑郁诊断。此外,更高的躯体疼痛与较低的 BMI 显著相关,而自尊是 T4 时康复的积极预测因素。较高的基线 BMI 和较短的疾病持续时间导致更好的结局。需要进一步研究以调查是否有终生抑郁、更高的躯体疼痛和更低自尊的 AN 患者可能受益于特定的治疗方法。