专门小组干预对神经性厌食症住院患者强迫性运动的疗效：一项随机对照试验。
Efficacy of a Specialized Group Intervention for Compulsive Exercise in Inpatients with Anorexia Nervosa: A Randomized Controlled Trial.
机构信息
Schoen Clinic Roseneck, Prien am Chiemsee, Germany,
Department of Clinical Psychology and E-Mental-Health, Technische Universität Dresden, Dresden, Germany,
出版信息
Psychother Psychosom. 2020;89(3):161-173. doi: 10.1159/000504583. Epub 2020 Feb 7.
INTRODUCTION
Treatment of compulsive exercise is recognized as a key unmet challenge in the treatment of anorexia nervosa (AN). To address this challenge, we developed the manualized group intervention "healthy exercise behavior" (HEB). This study evaluates the efficacy of HEB for the reduction of compulsive exercise as add-on to routine inpatient treatment (treatment as usual [TAU]) in a randomized controlled trial.
METHODS
Two hundred and seven adolescent and adult female inpatients with (atypical) AN were randomly allocated to TAU or to additional participation in HEB (TAU + HEB). HEB integrates elements of exercise-based therapy into a cognitive-behavioral approach. Assessments took place at admission, pre-intervention, post-intervention, discharge, and 6 months follow-up. Primary outcome was the severity of compulsive exercise assessed by the Commitment to Exercise Scale between pre- and post-intervention; secondary outcomes were additional aspects of compulsive exercise, assessed by the Compulsive Exercise Test, weight gain, eating disorder and general psychopathology, and emotion regulation.
RESULTS
In intention-to-treat analysis for the primary outcome, the TAU + HEB group showed significantly stronger reductions in the severity of compulsive exercise compared to the TAU group (z = -2.81; p = 0.005; effect size [ES] = -0.3). We also found significantly stronger reductions from admission to discharge (z= 2.62; p = 0.009; ES = -0.43), and from admission to follow-up (z = 2.1; p = 0.035; ES = -0.39). Regarding secondary outcomes, we found significant group differences between pre- and post-intervention in additional aspects of compulsive exercise (z = -2.55; p = 0.011; ES = -0.27). We did not find significant differences regarding weight gain, eating disorder and general psychopathology, and emotion regulation.
CONCLUSIONS
Our intervention proved efficacious in reducing compulsive exercise in inpatients with (atypical) AN.
简介
治疗强迫性运动被认为是治疗厌食症（AN）的一个关键未满足的挑战。为了应对这一挑战，我们开发了一种名为“健康运动行为”（HEB）的规范化小组干预措施。本研究通过随机对照试验评估了 HEB 对减少强迫性运动的疗效，该研究将其作为常规住院治疗（常规治疗[TAU]）的附加治疗。
方法
将 207 名患有（非典型）AN 的青少年和成年女性住院患者随机分配到 TAU 或额外参加 HEB（TAU+HEB）组。HEB 将基于运动的治疗元素融入认知行为方法中。评估在入院时、干预前、干预后、出院时和 6 个月随访时进行。主要结局是通过运动承诺量表评估的强迫性运动严重程度，评估时间为干预前后；次要结局是通过强迫性运动测试、体重增加、饮食障碍和一般心理病理学以及情绪调节评估的强迫性运动的其他方面。
结果
在主要结局的意向性治疗分析中，与 TAU 组相比，TAU+HEB 组的强迫性运动严重程度显著降低（z=-2.81;p=0.005;效应量[ES]为-0.3）。我们还发现，从入院到出院（z=2.62;p=0.009;ES=-0.43）以及从入院到随访（z=2.1;p=0.035;ES=-0.39），强迫性运动严重程度都有显著降低。关于次要结局，我们发现，在干预前后，在强迫性运动的其他方面，两组之间存在显著的组间差异（z=-2.55;p=0.011;ES=-0.27）。我们没有发现体重增加、饮食障碍和一般心理病理学以及情绪调节方面的显著差异。
结论
我们的干预措施在减少（非典型）AN 住院患者的强迫性运动方面是有效的。
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