Södersten P, Bergh C, Leon M, Brodin U, Zandian M
Karolinska Institutet, Section of Applied Neuroendocrinology, Mandometer Clinic, Huddinge, S-14104 Huddinge, Sweden.
Karolinska Institutet, Section of Applied Neuroendocrinology, Mandometer Clinic, Huddinge, S-14104 Huddinge, Sweden.
Physiol Behav. 2017 May 15;174:178-190. doi: 10.1016/j.physbeh.2017.03.016. Epub 2017 Mar 16.
We examine the science and evidence supporting cognitive behavior therapy (CBT) for the treatment of bulimia nervosa and other eating disorders. Recent trials focusing on the abnormal cognitive and emotional aspects of bulimia have reported a remission rate of about 45%, and a relapse rate of about 30% within one year. However, an early CBT trial that emphasized the normalization of eating behavior had a better outcome than treatment that focused on cognitive intervention. In support of this finding, another treatment, that restores a normal eating behavior using mealtime feedback, has an estimated remission rate of about 75% and a relapse rate of about 10% over five years. Moreover, when eating behavior was normalized, cognitive and emotional abnormalities were resolved at remission without cognitive therapy. The critical aspect of the CBT treatment of bulimia nervosa therefore may actually have been the normalization of eating behavior.
我们研究了支持认知行为疗法（CBT）治疗神经性贪食症和其他饮食失调症的科学依据。近期针对神经性贪食症异常认知和情绪方面的试验报告显示，缓解率约为45%，一年内复发率约为30%。然而，一项早期强调饮食行为正常化的CBT试验比专注于认知干预的治疗效果更好。为支持这一发现，另一项使用用餐时间反馈来恢复正常饮食行为的治疗方法，估计五年内缓解率约为75%，复发率约为10%。此外，当饮食行为正常化时，认知和情绪异常在缓解时无需认知疗法即可得到解决。因此，CBT治疗神经性贪食症的关键方面可能实际上是饮食行为的正常化。
