Voderholzer Ulrich, Naab Silke, Cuntz Ulrich, Schlegl Sandra
Schoen Clinic Roseneck, Prien a. Chiemsee, Germany.
Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany.
Nervenarzt. 2025 May 28. doi: 10.1007/s00115-025-01820-y.
Anorexia nervosa (AN) is a severe psychiatric disorder with the highest mortality rate among eating disorders. It predominantly affects adolescents and young adults, with a significant increase in prevalence among adolescents observed since the coronavirus disease 2019 (COVID-19) pandemic. It is frequently associated with other psychiatric disorders, such as depression, anxiety and obsessive-compulsive disorders as well as numerous physical complications. An early diagnosis and treatment are associated with better outcomes. The treatment of choice for AN includes cognitive behavioral therapy and family-based therapy for children and adolescents. Innovative treatment approaches, such as home treatment and technology-based interventions, have shown promising preliminary results. With the exception of moderate evidence supporting the use of olanzapine regarding weight gain, there is currently no evidence for the efficacy of psychopharmacotherapy in AN. Future research should focus on prevention, early detection and intervention, relapse prevention, personalized treatment approaches, management of comorbid disorders, long-term studies and the influence of psychosocial factors.
神经性厌食症（AN）是一种严重的精神疾病，在饮食失调中死亡率最高。它主要影响青少年和年轻人，自2019冠状病毒病（COVID-19）大流行以来，青少年中的患病率显著上升。它经常与其他精神疾病相关，如抑郁症、焦虑症和强迫症以及许多身体并发症。早期诊断和治疗与更好的结果相关。AN的首选治疗方法包括认知行为疗法和针对儿童及青少年的家庭疗法。创新的治疗方法，如家庭治疗和基于技术的干预措施，已显示出有前景的初步结果。除了有中等证据支持使用奥氮平促进体重增加外，目前没有证据表明精神药物治疗对AN有效。未来的研究应集中在预防、早期发现和干预、预防复发、个性化治疗方法、共病管理、长期研究以及社会心理因素的影响上。
