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儿童和青少年饮食失调心理社会治疗的循证更新

Evidence Based Update on Psychosocial Treatments for Eating Disorders in Children and Adolescents.

作者信息

Datta Nandini, Matheson Brittany E, Citron Kyra, Van Wye Eliza Margaret, Lock James D

机构信息

Department of Psychiatry and Behavioral Science, Stanford University School of Medicine.

出版信息

J Clin Child Adolesc Psychol. 2023 Mar-Apr;52(2):159-170. doi: 10.1080/15374416.2022.2109650. Epub 2022 Aug 11.

Abstract

Eating disorders (EDs) are life-threatening psychiatric illnesses that occur in adolescents. Unfortunately, limited randomized controlled trials exist to address EDs in this vulnerable population. The current review updates a prior review from 2015. The recommendations in this review build upon those that were previously published. This update was completed through a systematic search of three major scientific databases (PsychInfo, Pubmed, and Cochrane) from 2015 to 2022 (inclusively) from three databases, employing relevant medial subject headings. Additionally, expert colleagues were asked for additional literature to include. Thirty-one new studies were added to this review. Psychosocial treatments included family therapies, individual therapy, cognitive-behavioral therapy, interpersonal psychotherapy, cognitive training, dialectical behavioral therapy, and more recently, virtual or telehealth-based practices and guided self-help modalities for carers of youth with EDs. Using the methodological review criteria, this update found behavioral family-based treatment modalities (FBT) for both adolescent anorexia nervosa and bulimia nervosa met well-established treatment criteria. To date, there were no well-established treatments found for child and adolescent avoidant-restrictive food intake disorder, or binge eating disorder. Internet facilitated cognitive-behavioral therapy and family-based therapy were found to be possibly efficacious for binge eating disorder. Family-based treatment was found to be possibly efficacious for avoidant restrictive food intake disorder, with other clinical trials for cognitive treatment modalities under way. Ongoing research examining treatments for eating disorders in children and adolescents broadly is needed.

摘要

饮食失调(EDs)是发生在青少年中的危及生命的精神疾病。不幸的是,针对这一脆弱人群饮食失调问题的随机对照试验有限。本综述更新了2015年的一项前期综述。本综述中的建议以先前发表的建议为基础。此次更新是通过对2015年至2022年(含)三个主要科学数据库(PsychInfo、Pubmed和Cochrane)进行系统检索完成的,检索使用了相关医学主题词。此外,还向专家同事索要了其他要纳入的文献。本综述新增了31项新研究。心理社会治疗方法包括家庭治疗、个体治疗、认知行为治疗、人际心理治疗、认知训练、辩证行为治疗,以及最近出现的针对患有饮食失调症青少年的照顾者的虚拟或基于远程医疗的实践和引导式自助模式。根据方法学综述标准,此次更新发现,针对青少年神经性厌食症和神经性贪食症的基于行为家庭的治疗模式(FBT)符合既定的治疗标准。迄今为止,尚未发现针对儿童和青少年回避性限制性食物摄入障碍或暴饮暴食症的既定治疗方法。互联网辅助认知行为治疗和基于家庭的治疗被发现可能对暴饮暴食症有效。基于家庭的治疗被发现可能对回避性限制性食物摄入障碍有效,其他认知治疗模式的临床试验正在进行中。广泛开展针对儿童和青少年饮食失调治疗方法的持续研究很有必要。

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