Meule Adrian, Voderholzer Ulrich
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
Schoen Clinic Roseneck, Am Roseneck 6, 83209, Prien am Chiemsee, Germany.
J Eat Disord. 2022 Jul 18;10(1):106. doi: 10.1186/s40337-022-00629-3.
Obsessive-compulsive disorder (OCD) is one of the most prevalent comorbidities in anorexia nervosa (AN). As AN is a severe, life-threatening condition, reducing obsessive-compulsive symptomatology is not the primary objective during treatment of AN and, thus, these symptoms may remain unchanged or may even increase in terms of a "symptom shift".
In this retrospective analysis, we examined clinical records of 149 adolescents (n = 96, 64%) and adults (n = 53, 36%) with AN (6 males, 4%) who received inpatient treatment and completed the Obsessive-Compulsive Inventory-Revised at admission and discharge.
Obsessive-compulsive symptoms decreased from admission to discharge, irrespective of whether patients had comorbid OCD or not. Within-person decreases in obsessive-compulsive symptoms weakly correlated with increases in body weight.
These results indicate that obsessive-compulsive symptoms decrease during inpatient treatment of AN although they are not primarily targeted during treatment. Furthermore, these improvements seem to be associated with general improvements in AN symptomatology, suggesting the absence of a "symptom shift". Yet, effect sizes were small and obsessive-compulsive symptoms were still clinically elevated in patients with comorbid OCD at discharge, suggesting that these patients need OCD-specific, psychotherapeutic aftercare.
强迫症（OCD）是神经性厌食症（AN）中最常见的共病之一。由于AN是一种严重的、危及生命的疾病，减轻强迫症状并非AN治疗期间的主要目标，因此，这些症状可能保持不变，甚至可能出现“症状转移”而增加。
在这项回顾性分析中，我们检查了149例接受住院治疗的AN患者（6例男性，占4%）的临床记录，其中青少年96例（占64%），成年人53例（占36%），这些患者在入院和出院时均完成了修订版强迫观念及强迫行为问卷。
无论患者是否合并OCD，强迫症状从入院到出院均有所减轻。个体强迫症状的减轻与体重增加呈弱相关。
这些结果表明，AN住院治疗期间强迫症状会减轻，尽管治疗并非主要针对这些症状。此外，这些改善似乎与AN症状的总体改善相关，提示不存在“症状转移”。然而，效应量较小，合并OCD的患者出院时强迫症状在临床上仍较高，表明这些患者需要针对OCD的心理治疗后续护理。
