Ludwig-Maximilians-University (LMU), Munich, Department of Psychiatry and Psychotherapy, Munich, Germany.
Schoen Klinik Roseneck affiliated with the Medical Faculty of the University of Munich (LMU), Prien, Germany.
Int J Eat Disord. 2021 Apr;54(4):535-544. doi: 10.1002/eat.23443. Epub 2020 Dec 15.
To assess the ability of psychotherapists to predict the future outcome for inpatients with anorexia nervosa (AN) and bulimia nervosa (BN).
Psychotherapists rated the prognosis of the patient's eating disorder on a five point Likert scale on several dimensions at the end of inpatient treatment. Actual outcome was assessed about 10 years after treatment. The sample comprised 1,065 patients treated for AN, and 1,192 patients treated for BN.
Psychotherapists' rating of their patient's prognosis was not better than chance for good outcome in AN and BN and for poor outcome in BN. Prediction of poor outcome in AN was somewhat better with approximately two thirds of correct predictions. In logistic regression analysis, psychotherapists' rating of the patients' prognosis for AN contributed to the explained variance of long-term outcome, increasing the variance explained from 7% (by conventional predictors) to 8% after including psychotherapists' prognosis. In BN, there was no significant contribution of psychotherapists' prognosis to overall prediction.
Our current knowledge of risk and protective factors for the course of eating disorders is unsatisfying. More specialized research is urgently needed.
评估心理治疗师预测神经性厌食症（AN）和神经性贪食症（BN）住院患者未来结局的能力。
心理治疗师在住院治疗结束时，根据五点李克特量表，对患者的饮食障碍在多个维度上进行预后评估。大约在治疗 10 年后评估实际结局。样本包括 1065 例 AN 治疗患者和 1192 例 BN 治疗患者。
对于 AN 和 BN 的良好结局，以及 BN 的不良结局，心理治疗师对患者预后的评估并不优于随机猜测。对于 AN 的不良结局预测稍好一些，大约有三分之二的预测是正确的。在逻辑回归分析中，心理治疗师对 AN 患者预后的评估对长期结局的解释方差有贡献，在纳入心理治疗师的预后后，解释方差从 7%（通过传统预测因素）增加到 8%。在 BN 中，心理治疗师的预后对整体预测没有显著贡献。
我们目前对饮食障碍病程的风险和保护因素的了解并不令人满意。迫切需要更专门的研究。
