Compulsive exercise to control shape or weight in eating disorders: prevalence, associated features, and treatment outcome
Compulsive exercise to control shape or weight in eating disorders: prevalence, associated features, and treatment outcome
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DOI：
10.1016/j.comppsych.2007.12.007
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发表时间：
2008-07-01
影响因子：
7.3
通讯作者：
Marchesini, Giulio
中科院分区：
文献类型：
--
作者：
Dalle Grave, Riccardo;Calugi, Simona;Marchesini, Giulio
目的：本研究旨在评估强迫运动控制进食障碍（ED）患者体型和体重的流行率及其与治疗结果的关系。方法：控制体形和体重的强迫性运动，根据饮食失调检查（EDE）中控制体形或体重的剧烈运动部分的修改版本定义，在165名连续艾德住院患者中进行评估，这些患者进入了基于跨诊断认知行为理论和治疗ED的方案。基线评估还包括人体测量学、全球EDE访谈、贝克抑郁量表、状态-特质焦虑量表（STAI）、饮食障碍量表-完美主义量表以及气质和性格量表。45.5%的患者被归类为强迫运动者，其中限制型神经性厌食症（AN）的患病率最高（80%），未特别说明的ED最低（31.9%），暴食/泻药型AN（43.3%）和泻药型神经性贪食症（39.3%）居中。在校正艾德后，通过EDE约束评分（比值比，1.32; 95%置信区间，1.06-1.64; P = 0.014）独立预测控制体形和体重的强迫性锻炼;锻炼总量与EDE约束以及气质和性格量表奖励依赖性相关。在随访时，EDE总分的改善可通过较低的基线值、较高的基线STAI和STAI改善以及最后4周较低的运动量来预测。自愿治疗中止基线exercise.Discussion预测：强制行使控制形状和重量是限制型AN的行为特征，与约束和气质尺寸，与治疗结果的影响。(C)2008年爱思唯尔公司All rights reserved.
Objective: The study was aimed at assessing the prevalence of compulsive exercising to control shape and weight in eating disorders (EDs) and its relationship with treatment outcome.Method: Compulsive exercising to control shape and weight, defined according to a modified version of the Intense Exercising to Control Shape or Weight section of the Eating Disorder Examination (EDE), was assessed in 165 consecutive ED inpatients entering a protocol based on the transdiagnostic cognitive behavior theory and treatment of EDs. Baseline assessment also included anthropometry, the global EDE interview, the Beck Depression Inventory, the State-Trait Anxiety Inventory (STAI), the Eating Disorders Inventory-Perfectionism Scale, and the Temperament and Character Inventory.Results: Of the patients, 45.5% were classified as compulsive exercisers, the prevalence being highest (80%) in restricting-type anorexia nervosa (AN), lowest in EDs not otherwise specified (31.9%), and intermediate in binge/purging AN (43.3%) and in purging-type bulimia nervosa (39.3%). Compulsive exercising to control shape and weight was independently predicted by the EDE restraint score (odds ratio, 1.32; 95% confidence interval, 1.06-1.64; P = .014) after adjustment for ED; the total amount of exercise was associated with EDE restraint, as well as with the Temperament and Character Inventory reward dependence. At follow-up, an improved EDE global score was predicted by lower baseline values, higher baseline STAI and STAI improvement, and lower amount of exercise in the last 4 weeks. Voluntary treatment discontinuation was not predicted by baseline exercise.Discussion: Compulsive exercising to control shape and weight is a behavioral feature of restricting-type AN, associated with restraint and temperament dimensions, with influence on treatment outcome. (C) 2008 Elsevier Inc. All rights reserved.