Riesco Nadine, Agüera Zaida, Granero Roser, Jiménez-Murcia Susana, Menchón José M, Fernández-Aranda Fernando
Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.
Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.
Eur Psychiatry. 2018 Oct;54:109-116. doi: 10.1016/j.eurpsy.2018.08.001. Epub 2018 Sep 5.
with the DSM-5 new eating disorders (EDs) diagnostic subtypes were identified within the Other Specified Feeding or Eating Disorders (OSFED) category, which have so far been under-researched. Objectives of this study were to examine differential features among OSFED subtypes, exploring short-term cognitive-behavioral therapy (CBT) response and identifying clinical predictors of therapy outcome.
the sample included 176 female patients diagnosed with OSFED [82 atypical anorexia nervosa (atypical-AN), 57 purging disorder (PD), and 37 subthreshold bulimia nervosa (sub-BN)]. Assessment included eating-related, psychopathological and personality measures.
results showed similar clinical and personality profiles between the diagnostic subtypes, with hardly any differences, only observable in the core symptoms of each diagnosis. The sub-BN group was the one which showed more social impairment. Regarding treatment outcome, the three groups did not reveal significant differences in remission rates, therapeutic adherence or dropout rates, reaching rates of dropout from 36.8% to 50% (p = .391). However, different ED subtype predictors appear related with full remission or dropout risk, specifically personality traits.
our results suggest that OSFED patients may benefit similarly from the same CBT outpatient group approach. However, high dropout rates and low motivation seems to be an important limitation and challenge for future approaches.
随着《精神疾病诊断与统计手册》第五版（DSM - 5）的发布，在其他特定的喂养或进食障碍（OSFED）类别中确定了新的进食障碍（EDs）诊断亚型，而这些亚型迄今为止研究不足。本研究的目的是检查OSFED各亚型之间的差异特征，探索短期认知行为疗法（CBT）的反应，并确定治疗结果的临床预测因素。
样本包括176名被诊断为OSFED的女性患者[82例非典型神经性厌食症（非典型AN）、57例清除障碍（PD）和37例亚阈值神经性贪食症（亚BN）]。评估包括与饮食相关、精神病理学和人格测量。
结果显示诊断亚型之间的临床和人格特征相似，几乎没有差异，仅在每种诊断的核心症状中可观察到。亚BN组表现出更多的社会功能损害。关于治疗结果，三组在缓解率、治疗依从性或脱落率方面没有显著差异，脱落率在36.8%至50%之间（p = 0.391）。然而，不同的进食障碍亚型预测因素似乎与完全缓解或脱落风险相关，特别是人格特质。
我们的结果表明，OSFED患者可能从相同的CBT门诊小组治疗方法中获得类似的益处。然而，高脱落率和低动机似乎是未来治疗方法的一个重要限制和挑战。
