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一种基于神经生物学的 5 天多家庭治疗成人厌食症的可接受性、可行性和可能益处。

The acceptability, feasibility, and possible benefits of a neurobiologically-informed 5-day multifamily treatment for adults with anorexia nervosa.

机构信息

Department of Psychiatry, University of California San Diego, San Diego, California.

The Center for Balanced Living, Columbus, Ohio.

出版信息

Int J Eat Disord. 2018 Aug;51(8):863-869. doi: 10.1002/eat.22876. Epub 2018 May 2.

Abstract

OBJECTIVE

Novel treatments for adults with anorexia nervosa (AN) are lacking. Recent scientific advances have identified neurobiologically-driven temperament contributors to AN symptoms that may guide development of more effective treatments. This preliminary study evaluates the acceptability, feasibility and possible benefits of a multicenter open trial of an intensive 5-day neurobiologically-informed multifamily treatment for adults with AN and their supports (SU). The temperament-focused treatment combines psychoeducation of AN neurobiology and SU involvement to develop skills to manage traits contributing to disease chronicity.

METHOD

Fifty-four adults with AN and at least one SU (n = 73) received the 5-day treatment. Acceptability, feasibility, and attrition were measured post-treatment. Clinical outcome (BMI, eating disorder psychopathology, family function) was assessed post-treatment and at >3-month follow-up.

RESULTS

The treatment had low attrition, with only one drop-out. Patients and SU rated the intervention as highly acceptable, and clinicians reported good feasibility. At post-treatment, patients demonstrated significantly increased BMI, reduced eating disorder psychopathology, and improved family function. Benefits were maintained in the 39 patients who completed follow-up assessment, with 62% reporting full or partial remission.

DISCUSSION

Preliminary results are promising and suggest this novel treatment is feasible and acceptable. To establish treatment efficacy, fully-powered randomized controlled trials are necessary.

摘要

目的

成人厌食症(AN)的新疗法仍有待探索。最近的科学进展发现了与 AN 症状相关的神经生物学驱动的气质因素,这可能为开发更有效的治疗方法提供指导。本初步研究评估了一种针对成人 AN 及其支持者(SU)的强化 5 天神经生物学启发的多家庭治疗的多中心开放性试验的可接受性、可行性和潜在益处。以气质为重点的治疗结合了 AN 神经生物学的心理教育和 SU 的参与,以培养管理导致疾病持续性的特征的技能。

方法

54 名患有 AN 的成年人和至少一名 SU(n=73)接受了为期 5 天的治疗。治疗后评估可接受性、可行性和脱落情况。治疗后和>3 个月随访时评估临床结局(BMI、饮食障碍心理病理学、家庭功能)。

结果

治疗的脱落率低,仅有 1 人脱落。患者和 SU 对干预措施的评价非常高,临床医生报告了良好的可行性。治疗后,患者的 BMI 显著增加,饮食障碍心理病理学减少,家庭功能改善。在完成随访评估的 39 名患者中,有 62%报告完全或部分缓解。

讨论

初步结果令人鼓舞,表明这种新疗法是可行和可接受的。为了确立治疗效果,需要进行充分的随机对照试验。

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