Fahy T A, Russell G F
King's College Hospital, Institute of Psychiatry, De Crespigny Park, London, England.
Int J Eat Disord. 1993 Sep;14(2):135-45. doi: 10.1002/1098-108x(199309)14:2<135::aid-eat2260140203>3.0.co;2-d.
The purpose of this paper is to examine the factors that influence treatment response and outcome in 39 patients with bulimia nervosa who were assessed during the course of 8 weeks of cognitive-behavioral therapy, and after an 8-week and 1-year follow-up period. The patients' progress was assessed using data gathered from clinical examination, structured interviews, and self-rating scales. Patients who had a poor clinical response at the end of treatment had greater pretreatment symptom severity, lower body mass index, and were more likely to have personality disorders. Poor response after 1 year was associated with personality disorder, pretreatment symptom severity, and longer duration of illness. Patients without these poor prognostic indicators are more likely to respond to brief psychoeducational interventions. Patients with poor prognostic indicators are more suited to intensive psychological, pharmacologic, and experimental treatment approaches.
本文旨在研究在为期8周的认知行为疗法过程中接受评估的39例神经性贪食症患者，以及在8周和1年随访期后的治疗反应和结果的影响因素。使用从临床检查、结构化访谈和自评量表收集的数据评估患者的进展。治疗结束时临床反应不佳的患者治疗前症状严重程度更高、体重指数更低，且更有可能患有人格障碍。1年后反应不佳与人格障碍、治疗前症状严重程度和病程较长有关。没有这些不良预后指标的患者更有可能对简短的心理教育干预产生反应。具有不良预后指标的患者更适合强化心理、药物和实验性治疗方法。
