Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy.
Department of Psychological, Health and Territorial Sciences, G. D'Annunzio University, Chieti, Italy.
Eat Weight Disord. 2021 Dec;26(8):2513-2522. doi: 10.1007/s40519-021-01118-3. Epub 2021 Feb 3.
Recent studies demonstrated that the embodiment disorder represents a core feature of eating disorders (EDs). The aim of this study was to evaluate the role of its variation as a possible mediator of the efficacy of enhanced cognitive behavioural therapy (CBT-E) on classic ED symptomatology, including body uneasiness.
73 patients with anorexia nervosa and 68 with bulimia nervosa were treated with a multidisciplinary approach including CBT-E. Psychometric questionnaires were administered at baseline (T0) and after one (T1) and 2 years (T2) to evaluate general and ED-specific psychopathology, body uneasiness and the embodiment disorder. Data regarding diagnostic crossover and remission were also collected.
Longitudinal analysis showed an improvement of all psychopathological dimensions at T1, which remained stable at T2 (p < 0.05). Remission rate at T2 was 44.7%, and diagnostic crossover occurred in 17.0% of patients. Higher levels of embodiment disorder predicted increased diagnostic instability (OR: 1.80 [1.01-3.20], p = 0.045). The amelioration of the embodiment disorder mediated the decrease in both ED-specific psychopathology (indirect effect: 0.67 [0.46-0.92]) and body uneasiness (indirect effect: 0.43 [0.28-0.59]).
For the first time, these findings highlighted the role of the embodiment disorder as a maintaining factor of ED symptomatology, supporting the importance of integrating CBT-E with a phenomenological model of EDs.
Level IV, longitudinal observational study (case series).
最近的研究表明，身体意象障碍是饮食失调（EDs）的核心特征。本研究旨在评估其变化作为增强认知行为疗法（CBT-E）对经典 ED 症状，包括身体不适，疗效的可能中介的作用。
73 例神经性厌食症患者和 68 例神经性贪食症患者接受了包括 CBT-E 在内的多学科治疗。在基线（T0）、1 年（T1）和 2 年（T2）时，使用心理计量问卷评估一般和 ED 特异性精神病学、身体不适和身体意象障碍。还收集了关于诊断交叉和缓解的数据。
纵向分析显示，T1 时所有精神病理学维度均有所改善，T2 时仍保持稳定（p<0.05）。T2 时的缓解率为 44.7%，17.0%的患者发生了诊断交叉。身体意象障碍水平越高，诊断稳定性越差（OR：1.80 [1.01-3.20]，p=0.045）。身体意象障碍的改善介导了 ED 特异性精神病学（间接效应：0.67 [0.46-0.92]）和身体不适（间接效应：0.43 [0.28-0.59]）的降低。
这些发现首次强调了身体意象障碍作为 ED 症状维持因素的作用，支持将 CBT-E 与 ED 的现象学模型相结合的重要性。
IV 级，纵向观察研究（病例系列）。
