Kuipers G S, van der Ark L A, Bekker M H J
Tijdschr Psychiatr. 2020;62(2):148-156.
Attachment insecurity and difficulty with mentalization are common in patients with eating disorders and might be related to their symptoms and lack of autonomy.
AIM: To investigate the role of attachment and mentalization in the course of anorexia nervosa (AN) and bulimia nervosa (BN).
METHOD: Patients with AN and BN were assessed at the start of treatment, and after 1 year and 1.5 years concerning attachment security and mentalization in relation to eating disorder and co-morbid symptoms and autonomy. The results at the start of treatment were compared to those of controls without an eating disorder.
RESULTS: Attachment insecurity and low level of mentalization were more prevalent in patients than in controls, and associated with borderline personality disorder and/or self-injurious behaviour. Attachment security increased after 1 year of treatment. Recovery from eating disorder after 1 year was related to higher level of mentalization and improvement of autonomy. Low pre-treatment level of mentalization predicted persistence of eating disorder until 1.5 years of follow-up.
CONCLUSION: Good mentalization is associated with recovery from eating disorder. More research on the effect of mentalization based treatment for patients with eating disorders, with or without borderline personality disorder, is recommended.
依恋不安全感和心理化困难在饮食失调患者中很常见，可能与他们的症状和缺乏自主性有关。
研究依恋和心理化在神经性厌食症（AN）和神经性贪食症（BN）病程中的作用。
在治疗开始时、治疗1年后和1.5年后，对AN和BN患者进行评估，内容涉及与饮食失调、共病症状和自主性相关的依恋安全性和心理化。将治疗开始时的结果与无饮食失调的对照组结果进行比较。
与对照组相比，患者中依恋不安全感和心理化水平较低更为普遍，且与边缘性人格障碍和/或自我伤害行为相关。治疗1年后依恋安全性增加。1年后饮食失调的康复与较高的心理化水平和自主性改善有关。治疗前心理化水平低预示着饮食失调持续到随访1.5年。
良好的心理化与饮食失调的康复有关。建议对患有或未患有边缘性人格障碍的饮食失调患者进行更多基于心理化治疗效果的研究。
