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饮食失调住院患者的人格功能:与症状严重程度及治疗结果的关联

Personality Functioning in Inpatients With Eating Disorders: Association With Symptom Severity and Treatment Outcome.

作者信息

Heinzmann Sophia, Etzler Sonja, Hartmann Armin, Klein Eva M, Herpertz Stephan, Pape Magdalena, Heinzmann Stanislav, Doering Stephan, Hofmann Tobias, Rose Matthias, Imbierowicz Katrin, Geiser Franziska, Bierling Antonie, Weidner Kerstin, Rademacher Jörg, Michalek Silke, Morawa Eva, Erim Yesim, Skoda Eva-Maria, Teufel Martin, Peters Eva Milena Johanne, Kruse Johannes, von Boetticher Dirk, Herrmann-Lingen Christoph, Noehre Mariel, de Zwaan Martina, Dinger Ulrike, Friederich Hans-Christoph, Niecke Alexander, Albus Christian, Zwerenz Rüdiger, Beutel Manfred, Roenneberg Casper, Henningsen Peter, Stein Barbara, Waller Christiane, Hake Karsten, Spitzer Carsten, Stengel Andreas, Zipfel Stephan, Weimer Katja, Gündel Harald, Kessler Henrik, Spieler Derek, Lahmann Claas, Zeeck Almut

机构信息

Faculty of Medicine, Department of Psychosomatic Medicine and Psychotherapy, Center for Mental Health, University of Freiburg, Freiburg, Germany.

Protestant University of Applied Sciences Freiburg, Freiburg, Germany.

出版信息

Eur Eat Disord Rev. 2025 Jul;33(4):776-786. doi: 10.1002/erv.3183. Epub 2025 Feb 17.

Abstract

OBJECTIVE

Impairment in personality functioning (PF) has been linked to a number of mental disorders, including eating disorders (EDs). However, the precise relationship between PF and symptom severity, as well as the potential impact on outcome, remains unclear. The study aimed to analyse the association of PF and its change with severity of ED symptomatology as well as outcome of hospital treatment.

METHOD

The sample consisted of 397 patients with EDs, treated in 19 university hospitals for Psychosomatic Medicine and Psychotherapy in Germany between 1/2019 and 12/2020. PF was measured with the Structure Questionnaire of the Operationalised Psychodynamic Diagnosis (OPD-SQ, short version), eating psychopathology with the ED examination questionnaire (EDE-Q). Outcome was defined as a change in the EDE-Q total score. We used Latent Change Score Modelling to analyse changes in ED pathology during treatment and a 1-year follow-up period.

RESULTS

A higher level of impairment in PF at admission correlated with more eating psychopathology and a less favourable outcome. Additionally, greater improvement in PF correlated with greater improvements in ED symptomatology at discharge.

CONCLUSION

Impairment in PF needs to be part of diagnostic assessments and should be considered an important treatment target for psychotherapeutic interventions.

TRIAL REGISTRATION

The MEPP study was registered in the German Clinical Trials Register (DRKS, www.drks.de; ID: DRKS00016412).

摘要

目的

人格功能损害(PF)与多种精神障碍有关,包括饮食失调(EDs)。然而,PF与症状严重程度之间的确切关系以及对治疗结果的潜在影响仍不清楚。本研究旨在分析PF及其变化与ED症状严重程度以及住院治疗结果之间的关联。

方法

样本包括397例患有EDs的患者,于2019年1月至2020年12月期间在德国19家身心医学和心理治疗大学医院接受治疗。使用操作性精神动力诊断结构问卷(OPD-SQ,简版)测量PF,使用饮食失调检查问卷(EDE-Q)测量饮食精神病理学。结果定义为EDE-Q总分的变化。我们使用潜在变化分数模型分析治疗期间和1年随访期内ED病理的变化。

结果

入院时PF损害程度较高与更多的饮食精神病理学和更差的治疗结果相关。此外,PF的更大改善与出院时ED症状的更大改善相关。

结论

PF损害需要成为诊断评估的一部分,并应被视为心理治疗干预的重要治疗目标。

试验注册

MEPP研究已在德国临床试验注册中心(DRKS,www.drks.de;ID:DRKS00016412)注册。

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