Department of Internal Medicine, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.
Center for Excellence in Eating Disorders Tübingen (KOMET), Tübingen, Germany.
Expert Opin Ther Targets. 2023 Apr-May;27(4-5):281-292. doi: 10.1080/14728222.2023.2206954. Epub 2023 Apr 28.
Anorexia nervosa is a frequent eating disorder that affects predominantly young women and may take a severe and chronically worsening course of disease contributing to its high mortality rate. Although a multitude of treatment options exist, this disease still bears a high relapse rate. In light of these facts, an improvement of existing and development of new treatment targets and options is warranted.
The present review article covers recent developments in psychotherapy associated with the respective neuropsychological and brain alterations as well as highlights current and future pharmacotherapeutic options.
Several encouraging developments in the field of psychotherapy such as interventions targeting neurocognitive profiles or addressing reward processing, brain stimulation as well as pharmacological modulation of hormones, namely leptin, oxytocin, ghrelin and nesfatin-1 signaling might be - most likely as part of a multimodal treatment approach - efficacious in order to improve treatment of patients with anorexia nervosa, especially those with a severe course of disease as well as comorbidities. As anorexia nervosa represents a complex and severe mental disorder, it seems most likely that a combination and integration of different evidence-based treatment approaches and settings will contribute to an improved prognosis of this eating disorder. This should be further explored in future studies.
神经性厌食症是一种常见的饮食失调症,主要影响年轻女性,其疾病可能会严重且持续恶化,导致高死亡率。尽管有多种治疗选择,但这种疾病仍具有很高的复发率。鉴于这些事实,有必要改进现有的治疗方法,开发新的治疗靶点和选择。
本文综述了与相应的神经心理学和大脑改变相关的心理治疗的最新进展,并强调了当前和未来的药物治疗选择。
心理治疗领域的一些令人鼓舞的发展,如针对神经认知特征或解决奖励处理、脑刺激以及激素(如瘦素、催产素、胃饥饿素和 nesfatin-1 信号)的药理学调节等干预措施,可能会(最有可能作为多模式治疗方法的一部分)有效地改善神经性厌食症患者的治疗效果,特别是那些疾病严重和合并症的患者。由于神经性厌食症是一种复杂且严重的精神障碍,因此似乎最有可能的是,结合和整合不同基于证据的治疗方法和环境将有助于改善这种饮食失调症的预后。这应该在未来的研究中进一步探讨。