TREATMENT OF BULIMIA NERVOSA IN A PRIMARY CARE SETTING

描述(摘自申请人摘要)：神经性暴食症是一种 年轻女性中精神疾病发病率的主要来源，这通常会导致 慢性病程。人们普遍认为这种疾病是无法治疗的。 有效地在初级保健环境中使用。这一假设从来都不是 经过经验检验，很可能是不正确的。 在过去的15年里，对神经性暴食症的有效治疗干预 已经在专门的治疗中心开发和验证。这个 这项提案的主要目的是检查这些治疗方法是否适当 经调整，可有效地转移到一般保健环境。 具体地说，拟议的研究将确定相对和合并 两种主要疗法治疗儿童神经性贪食症的疗效比较 护理环境。两个主要的干预措施是使用 抗抑郁药物，氟西汀，并与认知形式 行为疗法，引导式自助，设计用于初级保健。 在四年多的时间里，200名患有神经性暴食症的女性将在 郊区的初级保健环境。病人将被随机分配到 接受(1)氟西汀或安慰剂，以及(2)引导自助 与医疗管理相结合或单独进行医疗管理。中的更改 饮食行为和心理状态将在#年末进行评估 积极治疗(4个月)，治疗结束后4个月和8个月。

DESCRIPTION (Adapted from the Applicant's Abstract): Bulimia Nervosa is a major source of psychiatric morbidity among young women, which often runs a chronic course. It is widely assumed that this disorder cannot be treated effectively in a primary care setting. This assumption has never been tested empirically, and is probably incorrect. In the last 15 years, effective treatment interventions for Bulimia Nervosa have been developed and validated in specialized treatment centers. The broad aim of this proposal is to examine whether these treatments, suitably adapted, can be usefully transferred to general health care settings. Specifically, the proposed study will determine the relative and combined effectiveness of the two leading treatments for Bulimia Nervose in a primary care setting. The two major interventions are treatment with an antidepressant medication, fluoxetine, and with a form of cognitive behavioral therapy, guided self-help, designed for use in primary care. Over four years, 200 women with Bulimia Nervosa will be treated in a suburban, primary care setting. Patients will be randomly assigned to receive (1) either fluoxetine or placebo and (2) either guided self-help combined with medical management or medical management alone. Changes in eating behavior and in psychological state will be assessed at the end of active treatment (4 months) and 4 and 8 months after the end of treatment.