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青少年和年轻成年人的饮食失调:对加拿大一个饮食失调治疗项目的项目评估。

Eating Disorders in Adolescents and Young Adults: A Program Evaluation of a Canadian Eating Disorder Treatment Program.

作者信息

Dewar-Morgan Caseita, Nippak Pria, Begum Housne, Remers Shannon, Rosenberg-Yunger Zahava, Meyer Julien M, Nippak Alaina

机构信息

Health Services Management, Ted Rogers School of Management, Toronto Metropolitan University, Toronto, CAN.

Research, Quality, and Outcomes, Homewood Health Inc., Guelph, CAN.

出版信息

Cureus. 2024 Nov 26;16(11):e74478. doi: 10.7759/cureus.74478. eCollection 2024 Nov.

Abstract

BACKGROUND

Current treatments for adolescents with eating disorders (ED) show limited effectiveness, emphasizing the need for enhanced therapeutic approaches. Cognitive behavioral therapy (CBT) has emerged as a potential alternative. A derivative of this approach, group cognitive behavioral therapy (G-CBT), has been shown to reduce treatment costs and increase treatment accessibility when compared to CBT. This program evaluation aimed to assess the effectiveness of G-CBT in adolescents and young adults diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN) and experiencing comorbid anxiety and depression within a Canadian mental health facility. The specific objectives were to determine if participants increased their knowledge about eating normalization and coping strategies after participating in the eating disorder (ED) treatment program and examine if participants experienced changes in eating-disordered behavior, anxiety, and mental health.

METHODS

We conducted a program evaluation using secondary data collected at admission and discharge from 44 adolescents and young adults (16-39 years) with AN or BN participating in the ED program at a Canadian health center. Outcome measures were eating psychopathology, depression, anxiety, and illness cognitions assessed using validated tools: Eating Disorder Examination Questionnaire (EDE-Q), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), and Illness Cognition Scale (ICS).

RESULTS

The mean age of participants was 24.1 years (standard deviation (SD) = 5.8). All outcome measures showed statistically significant improvement from admission to discharge (p < 0.001). Specifically, subscales of the EDE-Q (eating concern, weight concern, shape concern, and restraint) and the global score indicated a significant reduction in ED behaviors (p < 0.001).

CONCLUSION

Findings suggest that G-CBT is effective in reducing eating-disordered behavior, depression, anxiety, and maladaptive illness cognitions in adolescents and young adults with EDs. These results underscore the potential of G-CBT to address both behavioral and psychological aspects of ED recovery, although further studies with control groups are warranted to confirm these findings.

摘要

背景

目前针对饮食失调(ED)青少年的治疗效果有限,这凸显了加强治疗方法的必要性。认知行为疗法(CBT)已成为一种潜在的替代方法。与CBT相比,这种方法的一种衍生形式,即团体认知行为疗法(G-CBT),已被证明可以降低治疗成本并提高治疗的可及性。本项目评估旨在评估G-CBT在加拿大一家心理健康机构中对被诊断为神经性厌食症(AN)或神经性贪食症(BN)且伴有共病焦虑和抑郁的青少年及青年成人的有效性。具体目标是确定参与者在参加饮食失调(ED)治疗项目后是否增加了对饮食正常化和应对策略的了解,并检查参与者在饮食失调行为、焦虑和心理健康方面是否有变化。

方法

我们使用从44名年龄在16 - 39岁、患有AN或BN并在加拿大一家健康中心参加ED项目的青少年及青年成人入院和出院时收集的二手数据进行了项目评估。使用经过验证的工具评估结果指标,包括饮食心理病理学、抑郁、焦虑和疾病认知:饮食失调检查问卷(EDE-Q)、患者健康问卷-9(PHQ-9)、广泛性焦虑障碍量表-7(GAD-7)和疾病认知量表(ICS)。

结果

参与者的平均年龄为24.1岁(标准差(SD)= 5.8)。所有结果指标从入院到出院均显示出统计学上的显著改善(p < 0.001)。具体而言,EDE-Q的子量表(饮食关注、体重关注、体型关注和克制)以及总体得分表明饮食失调行为显著减少(p < 0.001)。

结论

研究结果表明,G-CBT在减少患有饮食失调症的青少年及青年成人的饮食失调行为、抑郁、焦虑和适应不良的疾病认知方面是有效的。这些结果强调了G-CBT在解决饮食失调康复的行为和心理方面的潜力,尽管有必要进行进一步的对照组研究来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd6e/11670144/edf81f3f90e6/cureus-0016-00000074478-i01.jpg

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