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使用生酮代谢疗法实现创伤后应激障碍、注意力缺陷多动障碍和暴饮暴食症中精神共病的跨诊断缓解:一项回顾性病例报告。

Transdiagnostic remission of psychiatric comorbidity in post-traumatic stress disorder, ADHD, and binge-eating disorder using ketogenic metabolic therapy: a retrospective case report.

作者信息

Bellamy Erin L, Laurent Nicole

机构信息

School of Psychology, University of East London, London, United Kingdom.

Family Renewal, Inc., Vancouver, WA, United States.

出版信息

Front Nutr. 2025 Jun 23;12:1600123. doi: 10.3389/fnut.2025.1600123. eCollection 2025.

Abstract

BACKGROUND

Psychiatric comorbidities, including post-traumatic stress disorder (PTSD), ADHD, and binge-eating disorder (BED), frequently share overlapping symptoms and metabolic dysfunctions. Disorder-specific treatments may not adequately address these shared biological mechanisms, resulting in suboptimal outcomes. This case report evaluates ketogenic metabolic therapy (KMT) as an intervention specifically targeting these transdiagnostic features.

METHODS

A 38 years-old female with PTSD, ADHD, BED, bipolar II disorder, depression, anxiety, and premenstrual dysphoric disorder diagnoses participated in a structured 8 weeks KMT psychoeducation program, with ongoing weekly professional and peer support up to 24 weeks. Standardized assessments, including the PHQ-9, GAD-7, DASS-21, PCL-5, BES, and CRAVED scales, measured symptom severity at baseline and 4 and 12 weeks. Daily biometric data including blood glucose and ketone levels were collected.

RESULTS

Baseline measures indicated severe psychiatric symptoms, notably maximal scores for PTSD and severe binge-eating behavior. By week 12, all psychiatric symptoms resolved evidenced by quantitative reductions to 0 across all validated instruments. The patient consistently reported optimal symptom control when blood ketone levels were maintained between 3 and 5 mmol/L. Qualitative reports substantiated marked functional gains, including improved occupational engagement and social functioning.

CONCLUSION

This report demonstrates the potential of KMT to achieve comprehensive remission in severe, treatment-resistant psychiatric comorbidities. The findings emphasize the necessity for controlled clinical trials to verify optimal therapeutic ketone ranges and establish generalizability across clinical populations experiencing complex psychiatric comorbidities.

摘要

背景

精神疾病共病,包括创伤后应激障碍(PTSD)、注意力缺陷多动障碍(ADHD)和暴饮暴食症(BED),常常存在重叠的症状和代谢功能障碍。针对特定疾病的治疗可能无法充分解决这些共同的生物学机制,导致治疗效果欠佳。本病例报告评估了生酮代谢疗法(KMT)作为一种专门针对这些跨诊断特征的干预措施。

方法

一名患有创伤后应激障碍、注意力缺陷多动障碍、暴饮暴食症、双相II型障碍、抑郁症、焦虑症和经前烦躁障碍的38岁女性参加了为期8周的结构化生酮代谢疗法心理教育项目,并在长达24周的时间里每周持续获得专业和同伴支持。采用标准化评估,包括PHQ-9、GAD-7、DASS-21、PCL-5、BES和CRAVED量表,在基线、第4周和第12周测量症状严重程度。收集包括血糖和酮水平在内的每日生物特征数据。

结果

基线测量表明存在严重的精神症状,尤其是创伤后应激障碍的最高分和严重的暴饮暴食行为。到第12周时,所有精神症状均得到缓解,所有经过验证的工具上的定量评分均降至0。患者持续报告称,当血酮水平维持在3至5 mmol/L之间时,症状得到了最佳控制。定性报告证实了显著的功能改善,包括职业参与度和社交功能的提高。

结论

本报告证明了生酮代谢疗法在严重的、难治性精神疾病共病中实现全面缓解的潜力。研究结果强调了进行对照临床试验以验证最佳治疗酮范围并确定在患有复杂精神疾病共病的临床人群中的普遍性的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bf9/12229880/2586990e8204/fnut-12-1600123-g001.jpg

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