Costandache Gina I, Munteanu Oana, Salaru Andra, Oroian Bianca, Cozmin Mihai
Department of Adult Psychiatry, Institute of Psychiatry "Socola", Iași, Romania.
Clinical Emergency Hospital for Children, Child and Adolescent Psychiatry Clinic, Cluj-Napoca, Romania.
Postep Psychiatr Neurol. 2023 Mar;32(1):40-48. doi: 10.5114/ppn.2023.127237. Epub 2023 May 8.
This article provides an overview of current treatment options for adults and adolescents suffering from eating disorders (ED).
ED are prevalent public health problems that considerably impair physical health and disrupt psychosocial functioning. In primary care settings, anorexia nervosa, bulimia nervosa, and binge eating disorder represent the most frequently seen types of eating disorders, in both adults and adolescents. To address these maladaptive eating-related behaviors and concurrent psychiatric symptoms, various pharmacological interventions and specialized psychological treatments have been evaluated and received support to varying degrees by controlled research.
The current literature regarding children and adolescents with eating disorders mainly supports the use of psychological interventions, such as family-based treatment and cognitive behavioral therapy. Due to the lack of robust evidence, the use of psychotropic medications is neither recommended nor approved in this population. For adults with eating disorders, an array of behaviorally focused psychotherapies, along with integrative and interpersonal approaches, can lead to the improvement of symptoms and the achievement of a healthy weight. Moreover, aside from psychotherapy, several pharmacological agents can contribute to the alleviation of eating disorders' clinical characteristics in the adult population. At the moment, the recommended psychotropic medication for eating disorders is represented by fluoxetine for bulimia nervosa and lisdexamfetamine for binge eating disorder.
本文概述了患有饮食失调（ED）的成人和青少年目前的治疗选择。
饮食失调是普遍存在的公共卫生问题，会严重损害身体健康并扰乱心理社会功能。在初级保健环境中，神经性厌食症、神经性贪食症和暴饮暴食症是成人和青少年中最常见的饮食失调类型。为了应对这些与饮食相关的适应不良行为和并发的精神症状，各种药物干预和专门的心理治疗已经得到评估，并在对照研究中得到了不同程度的支持。
目前关于患有饮食失调的儿童和青少年的文献主要支持使用心理干预，如基于家庭的治疗和认知行为疗法。由于缺乏有力证据，不建议也未批准在该人群中使用精神药物。对于患有饮食失调的成年人，一系列以行为为重点的心理治疗，以及综合和人际方法，可以改善症状并实现健康体重。此外，除了心理治疗外，几种药物制剂可以有助于减轻成人人群中饮食失调的临床特征。目前，推荐用于饮食失调的精神药物是用于神经性贪食症的氟西汀和用于暴饮暴食症的赖氨酸右旋苯丙胺。
