Munsch Simone, Messerli-Bürgy Nadine, Rubo Marius, Meyer Andrea H, Schopf Kathrin, Humbel Nadine, Forrer Felicitas, Adolph Dirk, Margraf Jürgen, Schneider Silvia
Clinical Psychology and Psychotherapy, Department of Psychology, Food Research and Innovation Center, FRIC, University of Fribourg, Fribourg, Switzerland.
Clinical Child and Adolescent Psychology, Department of Psychology, University of Lausanne, Lausanne, Switzerland.
PLoS One. 2025 Sep 8;20(9):e0329573. doi: 10.1371/journal.pone.0329573. eCollection 2025.
Eating disorders such as Anorexia Nervosa (AN) and Bulimia Nervosa (BN) were previously found to partly entail alterations in stress physiology including salivary cortisol (sC), and salivary alpha amylase (sAA) at rest and basal vagal tone (HF-HRV), compared to individuals without mental disorders or with mixed mental disorders (anxiety and depressive disorders), but corresponding data remain scarce and are not entirely consistent.
HF-HRV, sC and sAA at rest were assessed in a female sample of 58 individuals with AN and 54 individuals with BN before and after psychotherapy and contrasted against measurements from 59 female individuals suffering from mixed disorders and 101female healthy controls.
Values for sC were elevated in AN compared to all other groups, those for HF-HRV were highest in both AN and BN and lowest in mixed mental disorders and no differences were found at rest for sAA. During psychotherapy, HF-HRV changed more in AN and BN groups than in HC or mixed samples. sC and sAA remained unchanged. There was no association between BMI and stress physiology.
Alterations in stress physiology present differently across EDs and mixed mental disorders. Correlates of physiological functioning remained mostly stable throughout 3 months of psychotherapy. Only basal vagal tone was normalized in AN/BN in comparison to HC. This might indicate that physiological changes can occur early, but mostly take longer to change during treatment. Trial registration: Data were assessed during a multi-site cross- and longitudinal experimental trial registered at the German Clinical Trials Registry (trial number: DRKS00005709; see [1] for details).
与无精神障碍或患有混合性精神障碍（焦虑症和抑郁症）的个体相比，先前发现神经性厌食症（AN）和神经性贪食症（BN）等饮食失调症在一定程度上会导致应激生理学改变，包括静息时的唾液皮质醇（sC）、唾液α淀粉酶（sAA）以及基础迷走神经张力（HF-HRV），但相应数据仍然稀少且并不完全一致。
对58名患有AN的女性和54名患有BN的女性样本在心理治疗前后进行静息时的HF-HRV、sC和sAA评估，并与59名患有混合性障碍的女性个体和101名健康女性对照的测量结果进行对比。
与所有其他组相比，AN组的sC值升高，HF-HRV值在AN和BN组中最高，在混合性精神障碍组中最低，静息时sAA未发现差异。在心理治疗期间，AN组和BN组的HF-HRV变化比健康对照组或混合样本组更大。sC和sAA保持不变。BMI与应激生理学之间没有关联。
应激生理学改变在不同的饮食失调症和混合性精神障碍中表现不同。在为期3个月的心理治疗过程中，生理功能的相关指标大多保持稳定。与健康对照组相比，只有AN/BN组的基础迷走神经张力恢复正常。这可能表明生理变化可能在早期发生，但在治疗过程中大多需要更长时间才能改变。试验注册：数据是在德国临床试验注册中心注册的一项多中心交叉和纵向实验试验期间进行评估的（试验编号：DRKS00005709；详情见[1]）。
