Brain-gut psychotherapies: Promising tools to address gastrointestinal problems in patients with eating disorders.
Brain-gut psychotherapies: Promising tools to address gastrointestinal problems in patients with eating disorders.
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DOI：
10.1002/eat.23555
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Kells M
中科院分区：
文献类型：
--
作者：
Wildes JE;Bedell A;Graham AK;Kells M
胃肠道 (GI) 问题在饮食失调 (ED) 患者中很常见，并与痛苦、损伤和医疗保健利用率增加相关。进餐和其他对 ED 恢复至关重要的干预措施可能会加剧胃肠道症状，从而导致负面的临床结果。本文根据强调脑肠轴在胃肠道症状表达中的作用的模型，描述了一项针对 ED 的“脑肠心理疗法”的研究计划。首先，描述了脑肠轴在胃肠道症状中的作用，并回顾了基于证据的脑肠心理治疗，重点是针对胃肠道疾病的认知行为疗法和肠道定向催眠疗法。接下来，急诊科的未来研究方向是（a）了解胃肠道症状对病程和结果的影响； (b) 明确参与目标； (c) 评估脑肠心理疗法； (d) 描述优化干预范围和实施。我们提出了一个概念模型，强调胃肠道特异性焦虑和肠道生理学改变作为急诊科脑肠心理治疗的目标，并讨论了在设计临床试验来测试这些干预措施时需要解决的几个问题。我们还描述了与多学科利益相关者的接触和数字工具的使用如何加速从实验室到临床环境的转化。
Gastrointestinal (GI) problems are common in individuals with eating disorders (EDs) and associated with distress, impairment, and increased healthcare utilization. GI symptoms may be exacerbated by meals and other interventions central to ED recovery thereby contributing to negative clinical outcomes. Informed by models emphasizing the role of the brain-gut axis in the expression of GI symptoms, this article describes a program of research to adapt “brain-gut psychotherapies” for EDs. First, the role of the brain-gut axis in GI symptoms is described, and evidence-based brain-gut psychotherapies are reviewed, with an emphasis on cognitive behavioral therapy for GI disorders and gut-directed hypnotherapy. Next, future directions for research in EDs to (a) understand the impact of GI symptoms on illness course and outcome; (b) clarify target engagement; (c) evaluate brain-gut psychotherapies; and (d) optimize intervention reach and delivery are described. We present a conceptual model that emphasizes GI-specific anxiety and altered gut physiology as targets of brain-gut psychotherapies in EDs, and discuss several issues that need to be addressed in designing clinical trials to test these interventions. We also describe how engagement with multidisciplinary stakeholders and use of digital tools could speed translation from the laboratory to clinical settings.
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影响因子：
3.3
作者：
Labus, Jennifer S.;Mayer, Emeran A.;Naliboff, Bruce D.
通讯作者：
Naliboff, Bruce D.
影响因子：
7.6
作者：
Labus, JS;Bolus, R;Naliboff, BD
通讯作者：
Naliboff, BD
神经性厌食症的体重增加不会改善粪便菌群，分支链脂肪酸剖面和胃肠道抱怨。
影响因子：
4.6
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Mack I;Cuntz U;Grämer C;Niedermaier S;Pohl C;Schwiertz A;Zimmermann K;Zipfel S;Enck P;Penders J
通讯作者：
Penders J
影响因子：
9.3
作者：
Cuthbert BN;Insel TR
通讯作者：
Insel TR
影响因子：
3.5
作者：
Boyd, Catherine;Abraham, Suzanne;Kellow, John
通讯作者：
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