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治疗反应在神经性厌食症和非典型神经性厌食症之间是否存在差异?两项开放系列试验的结果。

Does response to treatment differ between anorexia nervosa and atypical anorexia nervosa? Findings from two open series trials.

机构信息

Department of Psychological Sciences, University of Louisville, Louisville, KY, United States of America.

Department of Psychological Sciences, University of Louisville, Louisville, KY, United States of America.

出版信息

J Affect Disord. 2024 Nov 15;365:451-458. doi: 10.1016/j.jad.2024.08.115. Epub 2024 Aug 23.

Abstract

BACKGROUND

No evidence-based treatments exist for atypical anorexia nervosa (AAN) and little is known about differences in response to treatment between anorexia nervosa (AN) and AAN. The purpose of this paper is to explore treatment outcomes in two pilot trials for those with AN and AAN.

METHODS

Study 1 (N = 127) examined treatment outcomes in a digital imaginal exposure trial and Study 2 (N = 34) examined outcomes in a personalized treatment trial. Participants with an active eating disorder (ED) were eligible and those with AN or AAN were included in these analyses. ED symptoms and ED-related fears were assessed at pre-treatment, post-treatment, and one and six-month follow-up. Linear mixed effects models explored treatment outcomes by diagnosis.

RESULTS

There were no significant differences in treatment response between diagnoses for most outcome measures. In Study 2, participants with AAN had a significant decrease in global ED symptoms across time, while AN did not.

LIMITATIONS

The samples were primarily white and female, limiting the generalizability of the studies. Additionally, due to limited consensus on "significant weight loss," a less conservative definition was used to diagnose AAN which may impact the results.

CONCLUSIONS

In general, those with AN and AAN may respond to treatment similarly, with some small differences. Digital exposure therapy may be effective treatments for both AN and AAN, especially for ED-related fears. Personalized treatment may be more effective for those with AAN than those with AN.

摘要

背景

目前针对非典型神经性厌食症(AAN)尚无循证治疗方法,对于神经性厌食症(AN)和 AAN 患者对治疗的反应差异知之甚少。本文旨在探讨针对 AN 和 AAN 患者的两项试点研究的治疗结果。

方法

研究 1(N=127)考察了数字化想象暴露试验中的治疗结果,研究 2(N=34)考察了个性化治疗试验中的治疗结果。有活跃饮食障碍(ED)的参与者符合条件,且将 AN 和 AAN 患者纳入这些分析。ED 症状和 ED 相关恐惧在治疗前、治疗后以及 1 个月和 6 个月随访时进行评估。线性混合效应模型通过诊断来探讨治疗结果。

结果

在大多数评估指标中,诊断之间的治疗反应没有显著差异。在研究 2 中,随着时间的推移,AAN 患者的总体 ED 症状显著下降,而 AN 则没有。

局限性

样本主要为白人和女性,限制了研究的普遍性。此外,由于对“显著体重减轻”缺乏共识,采用了不太保守的定义来诊断 AAN,这可能会影响结果。

结论

总体而言,AN 和 AAN 患者的治疗反应可能相似,存在一些细微差异。数字暴露疗法可能对 AN 和 AAN 均有效,尤其对 ED 相关恐惧有效。个性化治疗可能对 AAN 患者比 AN 患者更有效。

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