Kessler Ute, Kleppe Malin Mandelid, Rekkedal Guro Årdal, Rø Øyvind, Danielsen Yngvild
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
J Eat Disord. 2022 Feb 5;10(1):15. doi: 10.1186/s40337-022-00536-7.
Enhanced cognitive behavioral therapy (CBT-E) is a promising treatment option for outpatients with anorexia nervosa (AN). We aimed to determine the effectiveness of CBT-E as a standard treatment for adult outpatients with AN from the specialized eating-disorder unit of a public hospital with responsibilities to their catchment area.
This study had an open, longitudinal design. Thirty three (of planned 100) outpatients aged > 16 years suffering from AN were included to receive 40 sessions of CBT-E. Eating-disorder psychopathology and body mass index (BMI) were assessed before and after treatment, while comorbid psychiatric symptoms and trauma experiences were evaluated at the baseline, and therapeutic alliance was assessed after 4 weeks of treatment.
A high proportion (69%) of patients dropped out of the treatment. Patient recovery was considered when they reached BMI > 18.5 and Eating Disorder Examination Questionnaire (EDE-Q) score < 2.5, and 27% of all patients recovered.
Patients who completed the treatment had mostly satisfactory outcomes. Considering the high dropout rate, it is necessary to improve the strategies for engaging patients in therapy. Several aspects of CBT-E as a standard treatment are discussed regarding the high dropout rate. Trial registration ClinicalTrials.gov. Identifier: NCT02745067. Registered: April 20, 2016. https://clinicaltrials.gov/ct2/showNCT02745067.
强化认知行为疗法（CBT-E）是神经性厌食症（AN）门诊患者一种很有前景的治疗选择。我们旨在确定CBT-E作为公立医院专门饮食失调科针对其服务区域内成年AN门诊患者的标准治疗方法的有效性。
本研究采用开放、纵向设计。纳入了33名（计划纳入100名）年龄大于16岁的AN门诊患者，接受40节CBT-E治疗课程。在治疗前后评估饮食失调精神病理学和体重指数（BMI），在基线时评估共病精神症状和创伤经历，并在治疗4周后评估治疗联盟。
高比例（69%）的患者退出了治疗。当患者的BMI>18.5且饮食失调检查问卷（EDE-Q）得分<2.5时，视为患者康复，所有患者中有27%康复。
完成治疗的患者大多取得了令人满意的结果。考虑到高退出率，有必要改进使患者参与治疗的策略。针对高退出率讨论了CBT-E作为标准治疗方法的几个方面。试验注册ClinicalTrials.gov。标识符：NCT02745067。注册时间：2016年4月20日。https://clinicaltrials.gov/ct2/showNCT02745067 。
