The clinical utility of personality subtypes in patients with anorexia nervosa.
The clinical utility of personality subtypes in patients with anorexia nervosa.
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DOI：
10.1037/a0024597
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发表时间：
2011-10
影响因子：
5.9
通讯作者：
Forbush KT
中科院分区：
文献类型：
--
作者：
Wildes JE;Marcus MD;Crosby RD;Ringham RM;Dapelo MM;Gaskill JA;Forbush KT
阐明临床相关亚型已被提出作为推进治疗研究的一种手段，但将神经性厌食症（AN）患者分类为限制型和暴饮暴食/泻药型已证明预测有效性有限。本研究旨在评估一种基于共病人格精神病理学对进食障碍患者进行分类的方法是否可用于预测AN患者的治疗反应和再入院。数据收集自154例AN患者（M[SD]年龄= 25.6[9.4]岁; 95.5%为女性; 96.8%为白人）入院、出院和强化治疗出院后3个月。对入院时评估的人格特征进行潜在特征分析，将参与者分为人格亚型，然后用于预测出院时的结果和再入院的风险。最佳拟合模型确定了三种人格亚型（控制不足，过度控制，低精神病理学），这些亚型对预测研究结果的多变量模型有显著贡献。控制不佳的患者比控制过度的患者（OR = 3.56，p = 0.01）和低精神病理学水平的患者（OR = 11.23，p <0.001）更可能在出院时有不良结局。控制不佳的患者也有更大的风险出院的医疗建议（HR = 2.08，p = 0.02）和再入院比过度控制的患者（HR = 3.76，p = 0.009）。在多变量模型中，暴饮暴食/净化与限制亚型不能预测违背医嘱出院或再入院。研究结果支持AN人格亚型的临床实用性。未来的工作需要确定机制，解释治疗反应不佳的患者，并制定针对这一高危人群的干预措施。
Elucidation of clinically relevant subtypes has been proposed as a means of advancing treatment research, but classifying anorexia nervosa (AN) patients into restricting and binge-eating/purging types has demonstrated limited predictive validity. This study aimed to evaluate whether an approach to classifying eating disorder patients based on comorbid personality psychopathology has utility in predicting treatment response and readmission in patients with AN. Data were collected from 154 AN patients (M[SD] age = 25.6[9.4] years; 95.5% female; 96.8% Caucasian) at admission, discharge, and three months post-discharge from intensive treatment. Latent profile analysis of personality traits assessed at admission was performed to classify participants into personality subtypes, which were then used to predict outcomes at discharge and risk of readmission. The best-fitting model identified three personality subtypes (undercontrolled, overcontrolled, low psychopathology) that contributed significantly to multivariate models predicting study outcomes. Undercontrolled patients were more likely to have a poor outcome at discharge than overcontrolled (OR = 3.56, p = .01) and low psychopathology patients (OR = 11.23, p <.001). Undercontrolled patients also had a greater risk of discharge against medical advice (HR = 2.08, p = .02) and readmission than overcontrolled patients (HR = 3.76, p = .009). Binge-eating/purging versus restricting subtypes did not predict discharge against medical advice or readmission in the multivariate models. Findings support the clinical utility of personality subtypes in AN. Future work is needed to identify mechanisms that explain diminished treatment response in undercontrolled patients and to develop interventions for this high-risk group.
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影响因子：
6.9
作者：
Holliday, J;Landau, S;Treasure, J
通讯作者：
Treasure, J
DOI：
10.1016/j.jbtep.2010.04.001
发表时间：
2010-12-01
影响因子：
1.8
作者：
Kroeger, Christoph;Schweiger, Ulrich;Reinecker, Hans
通讯作者：
Reinecker, Hans
影响因子：
5.5
作者：
Birmingham, CL;Su, J;Gao, M
通讯作者：
Gao, M
影响因子：
3
作者：
BOZDOGAN, H
通讯作者：
BOZDOGAN, H
影响因子：
2.8
作者：
Krueger, Robert F.;Eaton, Nicholas R.
通讯作者：
Eaton, Nicholas R.