Ziser Katrin, Rheindorf Nadine, Keifenheim Katharina, Becker Sandra, Resmark Gaby, Giel Katrin E, Skoda Eva-Maria, Teufel Martin, Zipfel Stephan, Junne Florian
Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.
Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University Duisburg-Essen, Essen, Germany.
Front Psychiatry. 2021 Feb 1;12:632660. doi: 10.3389/fpsyt.2021.632660. eCollection 2021.
Patients with anorexia nervosa (AN) are frequently characterized by an unstable readiness to change and high ambivalence toward treatment. Enhancing readiness to behavioral change therefore plays an essential role for adherence to treatment especially for severely ill patients treated in inpatient settings. Therefore, a novel 10 week program for the individual psychotherapy sessions was designed using elements from motivational interviewing to be applied within the multidisciplinary inpatient treatment for patients with AN. In a randomized controlled pilot trial, = 22 patients with AN received either the new intervention or treatment as usual in one of two recruiting university hospitals. Readiness to change, eating disorder pathology, therapeutic alliance as well as acceptance and feasibility of the new intervention were measured from patients and therapists in week 1, 5, and 10 of inpatient treatment. Results confirm acceptance and feasibility of the MANNA intervention as evaluated by patients as well as therapists. Patients receiving the new intervention completed their inpatient treatment significantly more often on regular terms than patients receiving treatment as usual. No differences between the groups could be found concerning therapeutic alliance during and at the end of treatment and readiness to change. Absolute numbers of BMI increase indicate a larger increase in the intervention group albeit not significant in this pilot study sample. Limitations of the study such as the small sample size as well as possible adaptions and advancements of the intervention that need to be examined in a larger clinical trial of efficacy are discussed. This phase II study is registered with the German Clinical Trials Register (DRKS) under the trial number DRKS00015639.
神经性厌食症（AN）患者的特点往往是改变的意愿不稳定，对治疗存在高度矛盾心理。因此，增强行为改变的意愿对于坚持治疗至关重要，尤其是对于在住院环境中接受治疗的重症患者。为此，设计了一个为期10周的个体心理治疗课程，采用动机性访谈的元素，应用于AN患者的多学科住院治疗中。在一项随机对照试验中，22名AN患者在两家参与研究的大学医院之一接受了新干预措施或常规治疗。在住院治疗的第1周、第5周和第10周，对患者和治疗师测量了改变意愿、饮食失调病理、治疗联盟以及新干预措施的可接受性和可行性。结果证实了患者和治疗师评估的MANNA干预措施的可接受性和可行性。接受新干预措施的患者比接受常规治疗的患者更经常按时完成住院治疗。在治疗期间和结束时，两组在治疗联盟和改变意愿方面没有差异。体重指数增加的绝对数字表明干预组增加幅度更大，尽管在这个试验研究样本中不显著。讨论了该研究的局限性，如样本量小以及干预措施可能需要在更大规模的疗效临床试验中进行检验的调整和改进。这项II期研究已在德国临床试验注册中心（DRKS）注册，试验编号为DRKS00015639。
