The clinical basis of orthorexia nervosa: emerging perspectives
The clinical basis of orthorexia nervosa: emerging perspectives
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DOI：
10.2147/ndt.s61665
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发表时间：
2015-01-01
影响因子：
3.2
通讯作者：
Abry, Alexandra W.
中科院分区：
文献类型：
--
作者：
Koven, Nancy S.;Abry, Alexandra W.
神经性正食症描述了一种病理性的对适当营养的痴迷，其特征是限制性饮食、仪式化的饮食模式，以及严格避免被认为不健康或不纯的食物。虽然是出于追求最佳健康的愿望，但正食症可能会导致营养不足、医疗并发症和生活质量下降。尽管矫形症是临床医生经常观察到的一种独特的行为模式，但很少受到经验上的关注，而且还没有被正式承认为一种精神障碍。在这篇综述中，我们综合现有的研究，以确定什么是已知的症状，患病率，神经心理特征，和治疗矫形。对诊断界限的检查发现，神经性厌食症、强迫症(OCD)、强迫症(OCPD)、躯体症状障碍、疾病焦虑障碍和精神病谱系障碍之间的症状重叠的重要点。神经心理学数据表明，正食症症状与执行功能障碍的关键方面独立相关，其中一些条件已经重叠。对定势转移、外部注意和工作记忆中认知缺陷的讨论突出了持续研究的价值，以确定中间的、跨诊断的内表型，以深入了解正食障碍的神经发病机制。对目前矫形矫形术措施的评估表明，需要进一步发展心理测量学，以确保后续研究能够获得可靠和有效的评估工具。优化的评估不仅将允许更清楚地了解患病率、心理社会风险因素和共病的精神病理学，而且还需要对干预效果进行指数。尽管该领域缺乏治疗结果的数据，但目前的最佳实践表明，通过认知行为治疗、心理教育和药物治疗的组合，矫形症可以成功地得到治疗。
Orthorexia nervosa describes a pathological obsession with proper nutrition that is characterized by a restrictive diet, ritualized patterns of eating, and rigid avoidance of foods believed to be unhealthy or impure. Although prompted by a desire to achieve optimum health, orthorexia may lead to nutritional deficiencies, medical complications, and poor quality of life. Despite its being a distinct behavioral pattern that is frequently observed by clinicians, orthorexia has received very little empirical attention and is not yet formally recognized as a psychiatric disorder. In this review, we synthesize existing research to identify what is known about the symptoms, prevalence, neuropsychological profile, and treatment of orthorexia. An examination of diagnostic boundaries reveals important points of symptom overlap between orthorexia and anorexia nervosa, obsessive-compulsive disorder (OCD), obsessive-compulsive personality disorder (OCPD), somatic symptom disorder, illness anxiety disorder, and psychotic spectrum disorders. Neuropsychological data suggest that orthorexic symptoms are independently associated with key facets of executive dysfunction for which some of these conditions already overlap. Discussion of cognitive weaknesses in set-shifting, external attention, and working memory highlights the value of continued research to identify intermediate, transdiagnostic endophenotypes for insight into the neuropathogenesis of orthorexia. An evaluation of current orthorexia measures indicates a need for further psychometric development to ensure that subsequent research has access to reliable and valid assessment tools. Optimized assessment will not only permit a clearer understanding of prevalence rates, psychosocial risk factors, and comorbid psychopathology but will also be needed to index intervention effectiveness. Though the field lacks data on therapeutic outcomes, current best practices suggest that orthorexia can successfully be treated with a combination of cognitive-behavioral therapy, psychoeducation, and medication.