Thiebaut S, Millaud F, Lemaire P, Ryst A, Girod C, Seneque M, Dupuis-Maurin K, Sahuc N, Courtet P, Guillaume S
Service d'Urgences et post urgences psychiatriques, Hôpital Lapeyronie, avenue Gaston Giraud, 34295 Montpellier cedex 5, France.
Unité d'hospitalisation Farandole sur le pôle 30I03 au CH du Mas Careiron, chemin du paradis, 30700 UZES, France.
Encephale. 2022 Aug;48(4):430-435. doi: 10.1016/j.encep.2021.03.007. Epub 2021 Jul 5.
Management of anorexia nervosa is difficult and few treatments have shown their effectiveness, justifying the exploration of new therapeutic approaches. Available evidence suggests an interest of psychoeducational groups in a significant number of psychiatric disorders. In patients suffering from anorexia, to date there are few groups or interventions available. We aimed to assess the feasibility and acceptability of a psycho-educational program promoting information about the disease and presenting techniques that can help to cope with anorexia and the functional impact it causes. The exploratory secondary objectives were to evaluate if such a group is associated with clinical improvement.
Twenty-seven patients suffering from anorexia nervosa, in three groups, received eight weekly interventions in addition to their usual care. The study was open-label and non-randomized. Patients were assessed three times (baseline, at the end of the group and three months later). The assessments were both qualitative (Eating Disorder Examination questionnaire, The Anorexia Nervosa Stage of Change Questionnaire, the Eating Disorders Quality of Life questionnaire, Work and Social Adjustment Scale) and qualitative.
Seventy-eight percent of participants attended more than 75 % of the sessions. Seventy percent of participants found the group useful, and 95 % said it helped them improve their knowledge of the disease and its consequences. The average BMI of participants changed significantly with an average increase of 2.5kg between baseline and the three month assessment. There was an improvement of the eating disorders features in EDE-Q for the total score and for all subscores. The improvement in the total score was significant at the end of the group sessions, while the improvement in the sub scores became significant at three months. There was also a significant mood improvement at the end of the group. Finally, there was a significant improvement in daily functioning with a decrease in Work and Social Adjustment Scale scores and an improvement in quality of life. On qualitative assessment, patients were satisfied with the care proposal. They were able to appreciate the support and sharing of experience provided by the group formula. Most of them reported changes in their daily lives, either in their relationship to care and illness, or in their relationships with their loved ones, their leisure/work, their mood or their eating behavior.
Both qualitative and quantitative results suggest that this group psychoeducation program is feasible and well accepted by patients in addition to usual management. Although the methodology does not allow any conclusions, the clinical improvements observed during the group are encouraging with regard to the safety of this type of intervention and its possible effectiveness and argue for a controlled study.
神经性厌食症的管理颇具难度，鲜有治疗方法被证实有效，这使得探索新的治疗途径成为必要。现有证据表明，心理教育团体对众多精神疾病具有重要意义。对于神经性厌食症患者而言，目前可用的团体或干预措施较少。我们旨在评估一项心理教育项目的可行性和可接受性，该项目旨在传播有关该疾病的信息，并介绍有助于应对厌食症及其所致功能影响的技巧。探索性次要目标是评估这样一个团体是否与临床改善相关。
27名神经性厌食症患者被分为三组，除接受常规治疗外，每周接受八次干预。该研究为开放标签且非随机的。对患者进行了三次评估（基线、团体结束时和三个月后）。评估既有定量的（饮食失调检查问卷、神经性厌食症改变阶段问卷、饮食失调生活质量问卷、工作和社会适应量表），也有定性的。
78%的参与者参加了超过75%的课程。70%的参与者认为该团体有用，95%的参与者表示它帮助他们提高了对疾病及其后果的认识。参与者的平均体重指数有显著变化，从基线到三个月评估期间平均增加了2.5千克。在饮食失调检查问卷的总分及所有子分数方面，饮食失调特征均有改善。团体课程结束时总分的改善显著，而子分数的改善在三个月时变得显著。团体结束时情绪也有显著改善。最后，日常功能有显著改善，工作和社会适应量表得分降低，生活质量提高。在定性评估中，患者对护理方案感到满意。他们能够体会到团体形式所提供的支持和经验分享。他们中的大多数人报告说日常生活有了变化，无论是在与护理和疾病的关系上，还是在与亲人的关系、休闲/工作、情绪或饮食行为方面。
定性和定量结果均表明，除常规管理外，该团体心理教育项目对患者而言是可行且易于接受的。尽管该方法无法得出任何结论，但在团体期间观察到的临床改善在这类干预措施的安全性及其可能的有效性方面令人鼓舞，因此有必要进行对照研究。
