Department of Neuroscience, Psychiatry, Uppsala University, Entrance 10, Floor 3B, 751 85, Uppsala, Sweden.
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
J Behav Ther Exp Psychiatry. 2021 Jun;71:101637. doi: 10.1016/j.jbtep.2021.101637. Epub 2021 Jan 12.
No treatment for adult anorexia nervosa (AN) has shown sufficient effectiveness or superiority to other treatments. Overcontrol has been suggested as a viable mechanism to target in the treatment of patients with AN. Radically open dialectical behavior therapy (RO DBT) is developed for disorders related to maladaptive overcontrol. Our objective was to evaluate the outcome of RO DBT for AN in a clinical outpatient setting.
Thirteen adult female patients with mild to moderate AN provided written consent and entered a multiple baseline single-case experimental design study. Median age at eating disorder (ED) onset was 15 years and the median duration of the ED was 10 years. Individual changes were assessed weekly during a baseline phase (A) of four to six weeks, and during the subsequent 40-week RO DBT phase (B). Additional assessments were conducted before and after treatment, and at a six-month follow-up. Primary outcome was ED psychopathology. Secondary outcomes were psychosocial impairment, quality of life, social connectedness, and adaptive control strategies.
Eight patients (62%) completed treatment. All completers were in full remission after treatment, with BMI ≥18.5 kg/m and ED psychopathology within one standard deviation of the community mean. Improvements occurred after introducing RO DBT, not during baseline.
Participants were female with mild to moderate AN, limiting generalizability to severe AN or males.
The study provides preliminary support for using RO DBT in adult outpatients with AN and overcontrol. Further studies should replicate these findings.
目前尚无治疗成人厌食症（AN）的方法显示出足够的有效性或优于其他治疗方法。过度控制已被认为是治疗 AN 患者的可行机制。激进开放式辩证行为疗法（RO DBT）是为与适应不良过度控制相关的障碍而开发的。我们的目的是在临床门诊环境中评估 RO DBT 对 AN 的治疗效果。
13 名患有轻度至中度 AN 的成年女性患者书面同意并参加了一项多项基线单病例实验设计研究。进食障碍（ED）发病的中位年龄为 15 岁，ED 的中位持续时间为 10 年。在基线阶段（A）的四到六周期间每周评估个体变化，随后进行 40 周的 RO DBT 阶段（B）。在治疗前后和六个月随访时进行额外评估。主要结果是 ED 病理学。次要结果是心理社会障碍、生活质量、社交联系和适应性控制策略。
8 名患者（62%）完成了治疗。所有完成者在治疗后均完全缓解，BMI≥18.5 kg/m2，ED 病理学在社区平均值的一个标准差内。在引入 RO DBT 后出现了改善，而不是在基线期间。
参与者为女性，患有轻度至中度 AN，限制了严重 AN 或男性的普遍性。
该研究为使用 RO DBT 治疗成人门诊 AN 和过度控制提供了初步支持。应进一步研究复制这些发现。
