A systematic review of cognitive behavior therapy and dialectical behavior therapy for adolescent eating disorders.
A systematic review of cognitive behavior therapy and dialectical behavior therapy for adolescent eating disorders.
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DOI：
10.1186/s40337-021-00461-1
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发表时间：
2021-10-18
影响因子：
4.1
通讯作者：
Accurso EC
中科院分区：
文献类型：
--
作者：
Vogel EN;Singh S;Accurso EC
饮食失调会造成严重的心理和身体后果。目前针对青少年饮食失调的循证治疗效果有限，这凸显了改进当前治疗方法的必要性。认知行为疗法（CBT）和辩证行为疗法（DBT）已被提议作为替代治疗选择，该领域的研究正在蓬勃发展。本综述旨在总结和批判性分析当前关于 CBT 和 DBT 治疗青少年饮食失调的可行性、可接受性、有效性和功效的文献，然后提出未来的研究领域。使用系统评价和荟萃分析指南的首选报告项目对 PsycINFO 和 PubMed 进行检索，以确定检查 CBT 或 DBT 对青少年饮食失调的可行性、可接受性、有效性和/或功效的研究。合格的研究（N = 50；CBT：n = 40，DBT：n = 10）表明，这两种治疗方法在诊断和护理水平上对于青少年饮食失调都是合理可行的、可接受的，并且可能有效，尽管缺乏疗效试验。 CBT 和 DBT 有望替代基于家庭的青少年饮食失调方法。需要进行足够有力的试验来确定 CBT 和 DBT 的有效性和功效，特别是将这些治疗方法与其他主要方法进行比较的试验。尽管复发率很高，并且有可能患上严重和持久的疾病，但针对患有饮食失调的青少年，仍缺乏基于证据的治疗选择。针对饮食失调青少年的潜在可行但研究较少的治疗方法包括认知行为疗法（CBT）和辩证行为疗法（DBT）。这项针对青少年饮食失调的 CBT 和 DBT 的系统评价重点关注可行性（即实施治疗的容易程度）、可接受性（即患者和治疗师对干预措施的接受程度）、有效性（即干预措施在常规、现实环境下的执行情况）和功效（即干预措施在高度控制的研究环境中执行的情况）。本综述的结论是，研究支持这些方法的可行性和可接受性，以及其有效性的初步证据。然而，该领域缺乏系统地将 CBT 和 DBT 与其他循证方法进行比较的研究。提出了推进针对青少年饮食失调的 CBT 和 DBT 研究的建议，包括呼吁进行功效研究，以澄清其与其他主要方法相比的表现。
Eating disorders have serious psychological and physical consequences. Current evidence-based treatments for adolescents with eating disorders have modest effects, underscoring the need to improve current treatment approaches. Cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT) have been proposed as alternative treatment options, with burgeoning research in this area. This review aims to summarize and critically analyze the current literature on the feasibility, acceptability, effectiveness, and efficacy of CBT and DBT for adolescent eating disorders, and then proposes areas of future research. PsycINFO and PubMed were searched using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to identify studies examining the feasibility, acceptability, effectiveness and/or efficacy of CBT or DBT for adolescent eating disorders. Eligible studies (N = 50; CBT: n = 40, DBT: n = 10) indicated that both treatments are reasonably feasible, acceptable, and possibly effective for adolescent eating disorders across diagnoses and levels of care, though efficacy trials are lacking. CBT and DBT demonstrate promise as alternatives to family-based approaches for adolescent eating disorders. Adequately powered trials to establish the effectiveness and efficacy of CBT and DBT are needed, particularly ones that compare these treatments against other leading approaches. Despite high rates of relapse and likelihood for severe and enduring illness, there is a dearth of evidence-based treatment options for adolescents with eating disorders. Potentially viable but less well-studied treatments for adolescents with eating disorders include cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT). This systematic review of CBT and DBT for adolescent eating disorders focuses on feasibility (i.e., how easy it was to implement the treatment), acceptability (i.e., how well the intervention was received by patients and therapists), effectiveness (i.e., how well the intervention performed under routine, real-world circumstances), and efficacy (i.e., how well the intervention performed in highly-controlled research settings). This review concludes that research supports the feasibility and acceptability of these approaches, as well as preliminary evidence of their effectiveness. However, the field is lacking studies that systematically compare CBT and DBT to other evidence-based approaches. Recommendations to advance research on CBT and DBT for adolescent eating disorders are provided, including a call for efficacy studies that clarify their performance compared to other leading approaches.
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