Applying neurobiology to the treatment of adults with anorexia nervosa.
Applying neurobiology to the treatment of adults with anorexia nervosa.
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DOI：
10.1186/s40337-016-0119-x
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发表时间：
2016
影响因子：
4.1
通讯作者：
Kaye WH
中科院分区：
文献类型：
--
作者：
Hill L;Peck SK;Wierenga CE;Kaye WH
神经性厌食症是一种严重的、以生物学为基础的脑部疾病，具有显著的医学并发症。至关重要的是，开发新的、有效的治疗方法来中断由于医学和心理后遗症而导致的疾病的持续病程。研究了成人神经性厌食症的心理社会、行为和药物干预措施；然而，有证据表明，它们的影响很弱，治疗效果通常很小。本文描述了一种新的神经生物学神经性厌食症模型，该模型将焦点从单纯的外部影响（如社会和家庭）转移到包括跨年龄范围的整合遗传和神经生物学贡献的内部影响。该模型可作为本文概述的针对神经性厌食症的新的五天治疗的理论结构，该治疗将神经生物学维度整合到循证治疗干预中。治疗分为两个阶段。第一阶段是对成人神经性厌食症进行为期5天40小时的治疗。第二阶段是后续行动，目前正在拟订中。37名神经性厌食症成年人和60名支持者（如配偶、父母、阿姨、朋友、伴侣、神经性厌食症成年人的子女）的初步定性可接受性数据在第一阶段是有希望的。神经性厌食症患者及其支持者报告说，学习神经生物学事实提高了他们对疾病的理解，并帮助他们掌握更好的工具来管理神经性厌食症的特征和症状。此外，营养知识也发生了显著变化。这是第一个以神经生物学为基础，针对成人神经性厌食症及其支持者进行的为期五天的治疗。这是a新模型，概述了神经性厌食症的潜在遗传和神经生物学贡献，作为治疗特征和症状的基础。初步的定性发现是有希望的，客户和支持者都报告说，神经生物学治疗方法帮助他们更好地了解疾病，同时更好地概念化如何应对他们的特征和管理他们的症状。第一阶段的数据显示了作为神经性厌食症的神经生物学干预的前景，并为第二阶段的发展奠定了基础。正在进行的项目有效性的证据将被描述为第二阶段报告的数据。NCT02852538注册于2016年8月1日。本文的在线版本（doi:10.1186/s40337-016- 019 -x）包含补充材料，可供授权用户使用。
Anorexia nervosa is a severe, biologically based brain disorder with significant medical complications. It is critical that new, effective treatments are developed to interrupt the persistent course of the illness due to the medical and psychological sequelae. Several psychosocial, behavioral and pharmacologic interventions have been investigated in adult anorexia nervosa; however, evidence shows that their impact is weak and treatment effects are generally small. This paper describes a new neurobiological anorexia nervosa model that shifts focus from solely external influences, such as social and family, to include internal influences that integrate genetic and neurobiological contributions, across the age span. The model serves as a theoretical structure for a new, five-day treatment, outlined in this paper, targeting anorexia nervosa temperament, which integrates neurobiological dimensions into evidence-based treatment interventions. The treatment is in two phases. Phase I is a five day, 40 hour treatment for anorexia nervosa adults. Phase II is the follow-up and is currently being developed. Preliminary qualitative acceptability data on 37 adults with anorexia nervosa and 60 supports (e.g., spouses, parents, aunts, friends, partners, children of anorexia nervosa adults) are promising from Phase I. Clients with anorexia nervosa and their supports report that learning neurobiological facts improved their understanding of the illness and helped equip them with better tools to manage anorexia nervosa traits and symptoms. In addition, nutritional knowledge changed significantly. This is the first neurobiologically based, five-day treatment for adults with anorexia nervosa and their supports. It is a new model that outlines underlying genetic and neurobiological contributions to anorexia nervosa that serves as a foundation to treat both traits and symptoms. Preliminary qualitative findings are promising, with both clients and supports reporting that the neurobiological treatment approach helped them better understand the illness, while better conceptualizing how to respond to their traits and manage their symptoms. Data in Phase I shows promise as a neurobiologically based intervention for anorexia nervosa, and it serves as a foundation for the development of Phase II. Evidence of ongoing program efficacy will be described as data are reported on Phase II. NCT NCT02852538 Registered 1 August 2016. The online version of this article (doi:10.1186/s40337-016-0119-x) contains supplementary material, which is available to authorized users.