Department of Biostatistics & Health Informatics, London, UK.
Social, Genetic & Developmental Psychiatry Centre, London, UK.
Lancet Psychiatry. 2024 Dec;11(12):1030-1036. doi: 10.1016/S2215-0366(24)00186-X. Epub 2024 Aug 15.
The focus of mental health research in emerging fields should be driven by the priorities of people with relevant lived experience. Autism and ADHD are childhood-onset neurodevelopmental conditions that are associated with a range of health inequalities, including increased risk for eating disorders. The evidence base for how best to support neurodivergent individuals who experience disordered eating is still in its infancy, but research suggests that existing clinical approaches are not currently fit for purpose. In this Personal View, through community consultation with autistic people and people with ADHD who have experienced disordered eating, we present a comprehensive ranked list of research topics that people with lived experience prioritise. These priorities could be clustered into two areas: improving outcomes and identifying causal mechanisms. Within the theme of improving disordered eating outcomes, priorities are the improvement of treatment, the need for neurodiversity training in clinical services, and the identification and minimisation of unintended adverse effects of psychological intervention. Within the theme of identifying causal mechanisms, priorities are the identification of risk factors and a better understanding of the effect of autistic or ADHD neurocognitive profiles as potential contributors to eating disorder vulnerability. The final top ten research priorities are contextualised in terms of how they compare to the existing literature on the overlap between autism or ADHD and eating disorders, and concrete suggestions are made for how to implement these research priorities as testable hypotheses. Research informed by these priorities will build necessary understanding of the reasons behind the increased risk for eating disorders in neurodivergent people, and how to best support people who are affected by disordered eating to live positive and fulfilling lives.
精神健康研究新兴领域的重点应根据具有相关生活经验的人的优先事项来驱动。自闭症和注意力缺陷多动障碍是儿童期发病的神经发育障碍,与一系列健康不平等有关,包括饮食失调的风险增加。关于如何最好地支持经历饮食失调的神经多样性个体的证据基础仍处于起步阶段,但研究表明,现有的临床方法目前并不适用。在这篇个人观点中,我们通过与经历过饮食失调的自闭症患者和注意力缺陷多动障碍患者进行社区咨询,提出了一份由具有生活经验的人优先考虑的综合性研究课题排名清单。这些重点可以分为两个领域:改善结果和确定因果机制。在改善饮食失调结果的主题下,重点是改善治疗、在临床服务中进行神经多样性培训的需求,以及识别和最小化心理干预的意外不良影响。在确定因果机制的主题下,重点是确定风险因素,以及更好地理解自闭症或 ADHD 神经认知特征作为饮食障碍易感性潜在因素的影响。最后十个研究重点是根据它们与自闭症或注意力缺陷多动障碍与饮食失调之间重叠的现有文献进行背景化的,并就如何将这些研究重点作为可检验的假设来实施提出了具体建议。这些重点所指导的研究将有助于更好地理解神经多样性人群中饮食失调风险增加的原因,以及如何最好地支持受饮食失调影响的人过上积极充实的生活。