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针对神经性厌食症成人患者的跨专业强化认知行为疗法中的协作性饮食与心理护理:一种新型治疗方法。

Collaborative dietetic and psychological care in Interprofessional Enhanced Cognitive Behaviour Therapy for adults with Anorexia Nervosa: a novel treatment approach.

作者信息

Bray Megan, Heruc Gabriella, Byrne Susan, Wright Olivia R L

机构信息

School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.

Eating Disorders and Nutrition Research Group (ENRG), School of Medicine, Western Sydney University, Penrith, Australia.

出版信息

J Eat Disord. 2023 Feb 27;11(1):31. doi: 10.1186/s40337-023-00743-w.

Abstract

Clinical practice guidelines for anorexia nervosa (AN) and atypical anorexia nervosa recommend treatment from a team including a mental health professional and a dietitian. To date, however, AN treatment models such as Enhanced Cognitive Behaviour Therapy (CBT-E) seldom include dietitians and have low to moderate treatment efficacy. Given interprofessional approaches to healthcare have been shown to improve treatment outcomes and enhance patient and clinician satisfaction, formalising collaborative dietetic and psychological treatment may be a feasible strategy to improve treatment outcomes and the patient and clinician experience of treatment. Moreover, malnutrition is a serious consequence of AN, and dietitians are considered experts in its diagnosis and treatment. This paper proposes a novel treatment approach, Interprofessional Enhanced Cognitive Behaviour Therapy (CBT-IE), an adaptation of CBT-E where dietitians deliver content related to malnutrition and dietary restraint and mental health professionals deliver content related to cognitive and behavioural change. The rationale for developing CBT-IE, treatment structure, and future research directions is discussed.

摘要

神经性厌食症(AN)和非典型神经性厌食症的临床实践指南建议由包括心理健康专业人员和营养师在内的团队进行治疗。然而,迄今为止,诸如强化认知行为疗法(CBT-E)等AN治疗模式很少有营养师参与,治疗效果为低到中等。鉴于跨专业医疗方法已被证明能改善治疗结果并提高患者和临床医生的满意度,将协作性饮食和心理治疗正规化可能是改善治疗结果以及患者和临床医生治疗体验的可行策略。此外,营养不良是AN的严重后果,而营养师被视为营养不良诊断和治疗方面的专家。本文提出了一种新的治疗方法,即跨专业强化认知行为疗法(CBT-IE),它是对CBT-E的一种改编,由营养师提供与营养不良和饮食限制相关的内容,心理健康专业人员提供与认知和行为改变相关的内容。文中讨论了开发CBT-IE的基本原理、治疗结构和未来研究方向。

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Current Therapeutic Approaches to Anorexia Nervosa: State of the Art.目前神经性厌食症的治疗方法:最新进展。
Clin Ther. 2021 Jan;43(1):85-94. doi: 10.1016/j.clinthera.2020.11.006. Epub 2020 Dec 5.

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