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针对近期发作的暴饮暴食/清除型进食障碍的项目主导和重点干预措施:在进食障碍首次发作快速早期干预(FREED)网络中的应用及结果

Programme-Led and Focused Interventions for Recent Onset Binge/Purge Eating Disorders: Use and Outcomes in the First Episode Rapid Early Intervention for Eating Disorders (FREED) Network.

作者信息

Allen Karina L, Courtney Laura, Croft Philippa, Hyam Lucy, Mills Regan, Richards Katie, Ahmed Muhammad, Schmidt Ulrike

机构信息

Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.

Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

出版信息

Int J Eat Disord. 2025 Feb;58(2):389-399. doi: 10.1002/eat.24343. Epub 2024 Nov 30.

Abstract

OBJECTIVE

We aimed to compare use of, and outcomes from, programme-led and focused interventions (guided self-help and 10 session cognitive behavioral therapy for eating disorders [CBT-T]) relative to other psychological therapies (including group and individual CBT for eating disorders [CBT-ED]) in a national sample of emerging adults receiving early intervention for a non-underweight binge/purge eating disorder.

METHOD

Data were drawn from 54 English eating disorder services using the First Episode Rapid Early Intervention for Eating Disorders (FREED) model. Participants (N = 1097) had a mean age of 18.95 years (SD 2.42) and diagnoses of bulimia nervosa (n = 506; 45%), binge eating disorder (n = 121; 11%), another specified feeding or eating disorder (n = 460; 42%), or an eating disorder, unspecified (n = 10, 1%). Linear mixed models were used to assess for effects of time and treatment on binge eating and purging, eating disorder psychopathology, depression/anxiety, and body mass index.

RESULTS

11% (n = 117) of patients received guided self-help and 24% (n = 268) received CBT-T. Baseline eating disorder psychopathology and depressive/anxiety symptoms did not differ significantly across the guided self-help, CBT-T, group CBT-ED, and individual CBT-ED conditions. All treatments were associated with significant reductions in symptoms over time. GSH and CBT-T performed comparably to longer CBT-ED.

DISCUSSION

We provide additional evidence for the effectiveness of GSH and CBT-T in the treatment of non-underweight binge/purge eating disorders. Programme-led and focused interventions may be under-utilized and future research should explore when they are offered, and when not, both within and outside of early intervention settings.

摘要

目的

我们旨在比较在一个接受非体重过轻的暴饮暴食/清除型饮食失调早期干预的全国性新兴成年人样本中,与其他心理治疗方法(包括饮食失调的团体和个体认知行为疗法 [CBT-ED])相比,由项目主导的干预措施和聚焦干预措施(自助引导和10节饮食失调认知行为疗法 [CBT-T])的使用情况及治疗效果。

方法

数据来自54个采用饮食失调首次发作快速早期干预(FREED)模型的英国饮食失调服务机构。参与者(N = 1097)的平均年龄为18.95岁(标准差2.42),诊断为神经性贪食症(n = 506;45%)、暴饮暴食症(n = 121;11%)、其他特定的喂养或饮食失调(n = 460;42%)或未特定的饮食失调(n = 10;1%)。线性混合模型用于评估时间和治疗对暴饮暴食和清除行为、饮食失调精神病理学、抑郁/焦虑以及体重指数的影响。

结果

11%(n = 117)的患者接受了自助引导,24%(n = 268)的患者接受了CBT-T。在自助引导、CBT-T、团体CBT-ED和个体CBT-ED条件下,基线饮食失调精神病理学和抑郁/焦虑症状没有显著差异。随着时间的推移,所有治疗都与症状的显著减轻相关。自助引导和CBT-T的表现与更长疗程的CBT-ED相当。

讨论

我们为自助引导和CBT-T治疗非体重过轻的暴饮暴食/清除型饮食失调的有效性提供了额外证据。由项目主导的干预措施和聚焦干预措施可能未得到充分利用,未来的研究应探讨在早期干预环境内外,何时提供这些措施以及何时不提供。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca26/11861885/badfd30428c6/EAT-58-389-g002.jpg

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