van Beers Ella, de Vries Irene, Planting Caroline, Christ Carolien, de Beurs Edwin, van den Berg Elske
Novarum Center for Eating Disorders & Obesity, Amstelveen, Netherlands.
Department of Clinical Psychology, Leiden University, Leiden, Netherlands.
Front Psychiatry. 2025 Feb 21;16:1523269. doi: 10.3389/fpsyt.2025.1523269. eCollection 2025.
Many people with eating disorders report having experienced childhood maltreatment or a traumatic event prior to developing an eating disorder. Although many people with eating disorders have significant traumatic exposure or symptoms of post-traumatic stress disorder, very little research has examined the effects of combined treatments for this group. The purpose of this systematic review was to synthesize all existing research on biological treatments for those with eating disorders and psychological trauma, evaluate their safety, and identify future areas of research in this area to support patients with eating disorders and psychological trauma.
A multi-step literature search, according to an protocol was performed on PubMed, Embase, APA PsycINFO, Web of Science, Scopus and Cochrane Central. Studies needed to include a biological intervention and report on at least one eating disorder or psychological trauma outcome. Given the limited research in this area, minimal exclusion criteria were applied. A quality assessment of all included studies was completed using the Risk of Bias in Non-Randomized Studies-or Interventions (ROBINS-I) tool.
After removing duplicates, 2623 article titles and abstracts were screened, with 43 articles selected for a full-text review. Following the full-text review, 11 articles met the inclusion criteria. The biological treatments examined included repurposed medications (n = 3), ketamine (n = 2), repetitive transcranial magnetic stimulation (rTMS; n = 2), deep brain stimulation (n =1) electroconvulsive therapy (ECT; n = 1), 3,4-methylenedioxymethamphetamine (MDMA; n = 1), and neurofeedback (n = 1). All studies reported on some improvement in either eating disorder or trauma pathology, with the strongest effect for repetitive transcranial magnetic stimulation and MDMA. While some effects were promising, missing data and selective reporting limited the interpretability of the findings. Adverse events across interventions were common.
Although psychological trauma is common in those with eating disorders, very few treatments have been evaluated in this population. Future work should aim to investigate biological treatments for those with co-occurring eating disorders and psychological trauma, as these evolving treatments show potential benefits for this complex group.
许多饮食失调患者报告称，在患上饮食失调之前曾经历过童年虐待或创伤性事件。尽管许多饮食失调患者有显著的创伤暴露或创伤后应激障碍症状，但针对这一群体的联合治疗效果的研究却非常少。本系统综述的目的是综合所有关于饮食失调和心理创伤患者生物治疗的现有研究，评估其安全性，并确定该领域未来的研究方向，以支持饮食失调和心理创伤患者。
根据方案在PubMed、Embase、APA PsycINFO、Web of Science、Scopus和Cochrane Central上进行了多步骤文献检索。研究需包括生物干预，并报告至少一项饮食失调或心理创伤结果。鉴于该领域研究有限，采用了最低排除标准。使用非随机研究或干预中的偏倚风险（ROBINS-I）工具对所有纳入研究进行了质量评估。
去除重复项后，筛选了2623篇文章标题和摘要，选择了43篇文章进行全文审查。经过全文审查，11篇文章符合纳入标准。所研究的生物治疗包括重新利用的药物（n = 3）、氯胺酮（n = 2）、重复经颅磁刺激（rTMS；n = 2）、深部脑刺激（n = 1）、电休克治疗（ECT；n = 1）、3,4-亚甲基二氧甲基苯丙胺（摇头丸；n = 1）和神经反馈（n = 1）。所有研究均报告了饮食失调或创伤病理学方面的一些改善，重复经颅磁刺激和摇头丸的效果最强。虽然有些效果很有前景，但数据缺失和选择性报告限制了研究结果的可解释性。各干预措施中的不良事件很常见。
尽管心理创伤在饮食失调患者中很常见，但针对这一人群的治疗评估很少。未来的工作应旨在研究饮食失调和心理创伤并发患者的生物治疗，因为这些不断发展的治疗方法对这一复杂群体显示出潜在益处。
