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在一个针对饮食失调的部分住院治疗项目中,对一组年轻患者的回避/限制性食物摄入障碍进行治疗。

Treatment of avoidant/restrictive food intake disorder in a cohort of young patients in a partial hospitalization program for eating disorders.

作者信息

Ornstein Rollyn M, Essayli Jamal H, Nicely Terri A, Masciulli Emily, Lane-Loney Susan

机构信息

Division of Adolescent Medicine and Eating Disorders, Penn State Hershey Children's Hospital, Hershey, Pennsylvania.

Icahn School of Medicine at Mount Sinai, New York, New York.

出版信息

Int J Eat Disord. 2017 Sep;50(9):1067-1074. doi: 10.1002/eat.22737. Epub 2017 Jun 23.

Abstract

OBJECTIVE

Avoidant/restrictive food intake disorder (ARFID) is a recently named condition to classify patients who present with restricted nutritional intake without body image distortion or fear of weight gain. We sought to compare treatment outcomes of patients with ARFID in a family-centered partial hospital program (PHP) to those with other eating disorders (ED).

METHOD

A retrospective chart review of 130 patients 7-17 years of age admitted to the program from 2008 to 2012 was performed. Intake and discharge data included: length of stay; percentage median body mass index (%MBMI); and scores on the Children's Eating Attitudes Test (ChEAT) and Revised Children's Manifest Anxiety Scale (RCMAS). Between and within group effects were measured for intake and discharge data.

RESULTS

Patients with ARFID spent significantly fewer weeks in program than those with anorexia nervosa (AN) and experienced a similar increase in %MBMI as patients with AN and other specified/unspecified feeding and eating disorders. All patients exhibited significant improvements in psychopathology over the course of treatment as measured by scores on the ChEAT and RCMAS.

DISCUSSION

Our findings suggest that patients with ARFID can be successfully treated in the same PHP as patients with other ED, with comparable improvements in weight and psychopathology over a shorter time period. Results are limited to patients with ARFID who exhibit an acute onset of severe food restriction. Future research should incorporate measures relevant to the diagnosis of ARFID and explore how patients with different ARFID subtypes may respond to various treatments.

摘要

目的

回避/限制性食物摄入障碍(ARFID)是一种最近命名的病症,用于对营养摄入受限但无身体形象扭曲或体重增加恐惧的患者进行分类。我们试图比较以家庭为中心的部分住院项目(PHP)中ARFID患者与其他饮食失调(ED)患者的治疗结果。

方法

对2008年至2012年入院的130名7至17岁患者进行回顾性病历审查。入院和出院数据包括:住院时间;中位数体重指数百分比(%MBMI);以及儿童饮食态度测试(ChEAT)和修订版儿童显性焦虑量表(RCMAS)的得分。对入院和出院数据测量组间和组内效应。

结果

ARFID患者在项目中的停留周数明显少于神经性厌食症(AN)患者,并且与AN患者以及其他特定/未特定的喂养和饮食失调患者的%MBMI增加情况相似。通过ChEAT和RCMAS得分衡量,所有患者在治疗过程中精神病理学方面均有显著改善。

讨论

我们的研究结果表明,ARFID患者可以在与其他ED患者相同的PHP中成功治疗,在较短时间内体重和精神病理学方面有类似改善。结果仅限于表现出严重食物限制急性发作的ARFID患者。未来的研究应纳入与ARFID诊断相关的测量方法,并探索不同ARFID亚型的患者对各种治疗的反应。

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