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饮食失调未满足的治疗需求:10多年来有何变化?一项更新的系统评价和荟萃分析。

The Unmet Treatment Need for Eating Disorders: What Has Changed in More Than 10 Years? An Updated Systematic Review and Meta-Analysis.

作者信息

Ali Kathina, Radunz Marcela, McLean Siân A, O'Shea Anne, Mavrangelos Teri, Fassnacht Daniel B, Hart Laura

机构信息

Discipline of Psychology, College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia.

School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.

出版信息

Int J Eat Disord. 2025 Jan;58(1):46-65. doi: 10.1002/eat.24306. Epub 2024 Oct 31.

Abstract

OBJECTIVE

A minority of individuals with eating disorders seek help from health professionals qualified to provide eating disorder care. This review assessed the proportion of individuals with eating disorders who had sought help or received treatment, as an update to an earlier review conducted more than a decade ago.

METHOD

Three databases were searched for studies that: (1) included a community sample of help-seekers and non-help seekers, (2) used a standardized eating disorder screening instrument, and (3) assessed the percentage of participants who had sought help specifically for eating disorder concerns.

RESULTS

Of 972 articles, 21 studies met inclusion criteria, representing 37,423 participants. The pooled proportion reporting help-seeking from any source (e.g., helpline, support groups, chat rooms as well as health professionals) was 30% and the pooled proportion reporting formal treatment seeking from health professionals (e.g., psychologist) specifically for eating disorder concerns was 32%. However, there was evidence of publication bias across studies.

DISCUSSION

These rates suggest little to no improvement in the unmet need for treatment since the last review with studies continuing to focus on white adult women. Help-seeking rates among other populations remain unclear and there is an urgent need to understand reasons for overall low help-seeking rates. Clear definitions and measures of help-seeking with appropriate distinctions between sources of help are needed to improve our understanding of help-seeking pathways and identify solutions to facilitate help-seeking. Better visibility of health professionals qualified to provide safe and effective eating disorder care could help reduce the substantial treatment gap.

摘要

目的

少数饮食失调患者会向有资质提供饮食失调护理的健康专业人员寻求帮助。本综述评估了寻求帮助或接受治疗的饮食失调患者的比例,作为对十多年前进行的早期综述的更新。

方法

检索了三个数据库,查找符合以下条件的研究:(1)纳入了寻求帮助者和未寻求帮助者的社区样本;(2)使用了标准化的饮食失调筛查工具;(3)评估了专门因饮食失调问题而寻求帮助的参与者的百分比。

结果

在972篇文章中,有21项研究符合纳入标准,涉及37423名参与者。报告从任何来源(如帮助热线、支持小组、聊天室以及健康专业人员)寻求帮助的合并比例为30%,报告专门因饮食失调问题而向健康专业人员(如心理学家)寻求正规治疗的合并比例为32%。然而,各研究存在发表偏倚的证据。

讨论

这些比率表明,自上次综述以来,未满足的治疗需求几乎没有改善,研究仍集中在成年白人女性身上。其他人群的寻求帮助率仍不明确,迫切需要了解总体寻求帮助率低的原因。需要有明确的寻求帮助的定义和衡量标准,并对不同帮助来源进行适当区分,以增进我们对寻求帮助途径的理解,并找到促进寻求帮助的解决方案。让有资质提供安全有效的饮食失调护理的健康专业人员更容易被看到,可能有助于缩小巨大的治疗差距。

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