Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18Th St, CA, 94143, San Francisco, USA.
Curr Psychiatry Rep. 2023 May;25(5):213-222. doi: 10.1007/s11920-023-01416-w. Epub 2023 Mar 30.
With the current review, we provide a brief summary of recent literature that tests clinically observable characteristics at baseline that may impact treatment response, across eating disorder diagnoses. We then provide a critical discussion regarding how researchers may shift their approach to this research to improve treatment implications and generalizability of these findings.
Recent work has broadly replicated prior findings suggesting a negative impact of lower weight status, poor emotion regulation, and early-life trauma on eating disorder treatment outcomes. Findings are more mixed for the relative contributions of illness duration, psychiatric comorbidity, and baseline symptom severity. Recent studies have begun to explore more specific domains of previously tested predictors (e.g., specific comorbidities) as well as previously neglected identity-related and systemic factors. However, recent research continues to use similar sampling techniques and approaches to analysis used in prior work. We propose that resolving remaining questions and illuminating predictors of treatment outcome in eating disorders requires a new approach to research sampling and study design. Suggested changes that can be applied within a traditional clinical trial framework may yield new insights with relevance across transdiagnostic eating disorder presentations.
通过本次综述,我们简要总结了近期文献,这些文献检验了基线时可能影响治疗反应的临床可观察特征,涉及各种饮食障碍的诊断。然后,我们就研究人员如何改变这种研究方法以提高治疗意义和这些发现的普遍性进行了批判性讨论。
最近的研究广泛复制了先前的发现,即较低的体重状态、情绪调节不良和早期生活创伤对饮食障碍治疗结果有负面影响。疾病持续时间、精神共病和基线症状严重程度的相对贡献的研究结果则更为复杂。最近的研究开始探索以前测试过的预测因素(例如特定的共病)以及以前被忽视的与身份相关和系统性因素的更具体领域。然而,最近的研究仍然使用与之前工作相同的采样技术和分析方法。我们提出,解决饮食障碍治疗结果预测方面的剩余问题并阐明预测因素需要对研究抽样和研究设计采用新方法。可以在传统临床试验框架内应用的建议性改变可能会产生新的见解,这些见解对跨诊断饮食障碍表现具有相关性。