Adamson James, Kinnaird Emma, Glennon Danielle, Oakley Madeleine, Tchanturia Kate
Department of Psychological Medicine, Kings College London, UK.
National Eating Disorder Service, South London and Maudsley NHS Foundation Trust, UK.
BJPsych Open. 2020 May 18;6(3):e51. doi: 10.1192/bjo.2020.36.
Patients with co-occurring anorexia nervosa and autism respond differently to eating disorder treatments. Previous interviews with patients with both conditions and clinicians working in eating disorder services has highlighted service and treatment adaptations might be beneficial and could improve outcomes for these individuals.
The aim of this study was to explore carers' experiences of current treatment approaches for people with autism who have anorexia nervosa, and their views on how these can be improved.
Ten carers of a loved one diagnosed with autism and anorexia nervosa were interviewed using a semi-structured interview schedule and the transcripts were analysed with thematic analysis.
Four key themes emerged from the interviews: the role of autism in anorexia nervosa, carers' problems with clinical services, the impact on carers and suggestions for future improvements.
Carers agreed that autism played a significant role in the development and maintenance of their daughters' anorexia nervosa. However, this comorbidity does not appear to be appropriately addressed in current treatment provisions. They described several difficulties, including problems getting an autism diagnosis and the perception that eating disorder services did not accept or adapt around the condition. This resulted in feelings of frustration and isolation for families, a scenario exacerbated by a perceived lack of support or specific resources for carers of individuals on the autism spectrum. Clinical recommendations on the basis of the current and previous studies are outlined.
同时患有神经性厌食症和自闭症的患者对饮食失调治疗的反应有所不同。此前对患有这两种疾病的患者以及在饮食失调服务机构工作的临床医生进行的访谈强调，服务和治疗的调整可能有益，并且可以改善这些患者的治疗效果。
本研究的目的是探讨照顾者对患有神经性厌食症的自闭症患者当前治疗方法的体验，以及他们对如何改进这些方法的看法。
使用半结构化访谈提纲对10位被诊断患有自闭症和神经性厌食症的患者的照顾者进行访谈，并对访谈记录进行主题分析。
访谈中出现了四个关键主题：自闭症在神经性厌食症中的作用、照顾者在临床服务方面遇到的问题、对照顾者的影响以及对未来改进的建议。
照顾者一致认为，自闭症在其女儿神经性厌食症的发展和维持中起到了重要作用。然而，目前的治疗方案似乎并未适当解决这种共病问题。他们描述了几个困难，包括难以获得自闭症诊断，以及认为饮食失调服务机构不接受或不适应这种情况。这导致家庭感到沮丧和孤立，而自闭症谱系患者的照顾者缺乏支持或特定资源的情况又加剧了这种局面。文中概述了基于当前和以往研究的临床建议。
