Department of Psychology, Wesleyan University, 207 High Street, Middletown, CT 06459, USA.
Department of Psychology, Manchester Community College, Manchester, CT, USA.
Behav Res Ther. 2017 Jan;88:49-64. doi: 10.1016/j.brat.2016.09.006.
Eating disorders are serious mental disorders as reflected in significant impairments in health and psychosocial functioning and excess mortality. Despite the clear evidence of clinical significance and despite availability of evidence-based, effective treatments, research has shown a paradox of elevated health services use and, yet, infrequent treatment specifically targeting the eating disorder (i.e., high unmet treatment need). This review paper summarizes key studies conducted in collaboration with G. Terence Wilson and offers an update of the research literature published since 2011 in three research areas that undergirded our collaborative research project: unmet treatment needs, cost of illness, and cost-effectiveness of treatments. In regards to unmet treatment needs, epidemiological studies find that the number of individuals with an eating disorder who do not receive disorder-specific treatment continues to remain high. Cost-of-illness show that eating disorders are associated with substantial financial burdens for individuals, their family, and society, yet comprehensive examination of costs across public sectors is lacking. Cost measures vary widely, making it difficult to draw firm conclusions. Hospitalization is a major driver of medical costs incurred by individuals with an eating disorder. Only a handful of cost-effectiveness studies have been conducted, leaving policy makers with little information on which to base decisions about allocation of resources to help reduce the burden of suffering attributable to eating disorders.
进食障碍是一种严重的精神障碍,表现为健康和心理社会功能显著受损以及死亡率过高。尽管有明确的临床意义证据,并且有基于证据的有效治疗方法,但研究表明存在一个悖论,即尽管卫生服务的利用率很高,但专门针对进食障碍的治疗却很少(即治疗需求未得到满足的情况很高)。本文综述了与 G. Terence Wilson 合作进行的一些主要研究,并更新了自 2011 年以来在三个支撑我们合作研究项目的研究领域中发表的研究文献:治疗需求未得到满足、疾病负担和治疗的成本效益。关于治疗需求未得到满足的问题,流行病学研究发现,患有进食障碍但未接受特定于疾病的治疗的人数仍然居高不下。疾病负担研究表明,进食障碍给个人、他们的家庭和社会带来了巨大的经济负担,但对公共部门的全面成本评估却缺乏。成本衡量标准差异很大,难以得出明确的结论。住院治疗是个人因进食障碍而产生的医疗费用的主要驱动因素。仅有少数成本效益研究已经进行,这使得决策者在决定如何分配资源以帮助减轻与进食障碍相关的痛苦负担方面几乎没有信息依据。