神经性贪食症的认知机制及认知行为治疗进展

近年来,神经性贪食症(BN)发病率逐渐上升,年轻女性发病率约3%~6%,男性约3%,女性终身患病率约2%~4%,成为青年人常见慢性心理疾病之一。国外研究认为,体像障碍和情绪认知障碍是BN的主要认知机制,基于此机制的认知行为治疗(Cognitive Behavioral Therapy,CBT)最近几年在实践中取得不少进展,从CBT到CBT-E(Cognitive Behavioral Therapy-Enhanced,CBT-E),进一步发展到CBT-GSH(Cognitive behavioral therapy-based guided self-help)。尽管CBT疗效显著,但仍需更多的理论上的突破和技术上的联合,比如治疗联盟和正念疗法的辅助,以达到更好的治愈效果。     

神经性贪食症的心理病理学研究现状

神经性贪食症的心理病理学研究现状左衍涛北京大学心理系神经性贪食症（ｂｕｌｉｍｉａｎｅｒｖｏｓａ，ＢＮ）与厌食症（ａｎｏｒｅｘｉａｎｅｒｖｏｓａＡＮ）一样，是一类严重的进食障碍。其基本特征是患者有反复发作的暴食行为，并有强烈的控制体重的先占观念。患者采...     

森田疗法治疗神经性贪食症一例

森田疗法治疗神经性贪食症一例北京医科大学精神卫生研究所孟凡强，候冬芬，崔玉华患者冉某，女，２４岁，大学文化。自幼生长发育好，１３岁月经初潮，规律。１５岁时身高１．５４米，体重６５公斤，人称小胖胖。一次偷吃母亲留下的食物怕长胖遂引吐。其后引吐次数渐多致...     

神经性贪食症的心理干预

神经性贪食症(Bulimia Nervosa,BN)的治疗中,常采用心理干预的方法.本文对BN的心理干预研究进行系统的回顾,以确定不同干预方法的有效性、安全性及相关影响因素,并结合国内研究现状对其进行评价和展望.     

行为矫正合并抗抑郁药治疗神经性厌食伴贪食症1例报告

行为矫正合并抗抑郁药治疗神经性厌食伴贪食症１例报告四川省内江市第二人民医院精神科袁有才李惠英患者，女，１８岁，学生。因持续厌食，消瘦，闭经伴贪食２年于１９９４年８月２３日住我科。入院前２年患者作为主持人组织校联欢晚会彩排时，一男生夸到：“你要是再瘦点...     

8例神经性贪食症整合性心理治疗总结

８例神经性贪食症整合性心理治疗总结泉州市第三医院吴积涵，翁信会符合ＣＣＭＤ—Ⅱ诊断标准的８例贪食症患者整合性心理治疗结果总结如下：临床资料男３例，女５例；年龄平均２０．６±２．１岁；学生６例，营业员１例，待业１例；高中３例，技校２例，大学３例；病程平...     

神经性贪食症的发生率,危险因素及心理治疗

神经性贪食症的发生率、危险因素及心理治疗北京大学心理系左衍涛神经性贪食症（ＢＮ）和厌食症（ＡＮ）是　　　许多工业化社会中比较严重的大众健康问题　　　之一。自１９８０年ＤＳＭ─Ⅲ将贪食症确认为独立的临床类型以来，有关ＢＮ的研究在国外已迅速发展起来。近年...     

催眠疗法合并药物治疗神经性贪食症1例

神经性贪食是一种进食障碍,特征为反复发作和不可抗拒的摄食欲望及暴食行为,病人有担心发胖的恐惧心理,常采取引吐,导泻、禁食等方法以消除暴食引起发胖的极端措施。     

贪食症、暴食症虚拟现实暴露疗法干预及机制

虚拟现实(Virtual Reality, VR)技术的出现,为以暴食行为(BE,Binge Eating)为主要病症的进食障碍(EDs, Eating Disorders),包括暴食症(Binge Eating Disorder, BED)和神经性贪食症(Bulimia Nervosa, BN)的干预提供了新的思路。本文总结了近年来国内外运用虚拟现实技术对暴食症及贪食症患者的相关研究,整理不同VR模型对BED/BN人群的干预及机制,从情感及认知的视角探究了虚拟现实技术的干预机制。未来将通过虚拟现实技术与神经反馈的结合,调节患者的情感和认知,开拓更多的治疗前景。     

神经性厌食症患者家庭治疗疗效观察

目的 观察神经性厌食症(AN)患者家庭治疗疗效.方法 将符合神经性厌食症患者30例,给予家庭治疗,并对其疗效进行现察,包括治疗前后身高体重的测量,计算身高体重指数(BMT).结果 AN患者治疗后体重(48.57±9.36)Kg,显著高于治疗前(44.12±9.78)Kg(P＜0.05),治疗后BMI(18.08±2.9...     

Evaluation and deployment of evidence based patient self-management support program for Bulimia Nervosa

OBJECTIVE: This article presents initial results from a European multi-centre study to determine the effectiveness and feasibility of an online self-help treatment support program for Bulimia Nervosa (BN). METHOD: The online program is based on Cognitive Behavioral Therapy (CBT) and consists of seven steps that patients work through progressively. An overall sample of 141 women suffering from BN used the program over a 6-month period. Patients were supported by three face-to-face evaluation interviews with a therapist, and a weekly e-mail contact. Data on general psychopathology and specific eating disorder symptoms were also collected at the evaluation interviews. RESULTS: Initial results from the Swiss sample (N=41) showed significant improvement of overall psychological health (p<.001) as measured by the Symptom Checklist (SCL-90R), and for all dimensions of the Eating Disorder Inventory (EDI-2). CONCLUSION: An online Self-Help program for BN can be used effectively to reduce eating disorder symptoms in Bulimic patients and user feedback showed that this approach contributed to increase patient involvement and service availability. Additional data from the other centers will further inform the efficacy and impact of this approach.     

Eating disorders: clinical features and pathophysiology

Anorexia nervosa (AN) and bulimia nervosa (BN) are disorders of eating and weight-related behavior that together afflict some 1-3% of women in the United States. One of the remarkable features about each of the eating disorders is how persistent the disordered eating behavior becomes once it has begun. Substantial psychological, social, and physiological disturbances are associated with eating disorders, and it has been very difficult to disentangle those factors that may result from the disturbed behavior from the factors that may have predisposed individuals to, or precipitated the development of, the disorder. This article will briefly review the definitions, phenomenology, and identified risk factors for development of each of the major eating disorders. Pathophysiology will be discussed, with a particular focus on candidate factors that might sustain disordered eating behavior, as informed by clinical and basic science research. Future research directions will be suggested.     

神经性厌食症患者进食障碍与家庭功能关系的研究

目的 探讨神经性厌食症(AN)患者进食障碍及其与家庭功能的关系.方法 使用进食障碍调查量表(EDI),家庭功能量表(FAD)对29例AN患者的进食障碍及其家庭功能进行评定,对其身高体重指数(BMI)进行计算,并与大学生样本进行对照研究.结果 AN患者EDI对瘦的追求,贪食,对身体不满意,无效感,完美主义,对他人不信任,...     

A Genetic Analysis of the Eating and Attitudes Associated with Bulimia Nervosa: Dealing with the Problem of Ascertainment in Twin Studies

Little is known about the etiology of bulimia nervosa and the attitudes associated with it. We have undertaken a study of selected (45 pairs) and unselected (106 pairs) female twins to elucidate the broad causes of individual differences in these behaviours and attitudes. The selected sample was chosen on the basis of at least one of the twin pair having a lifetime incidence of bulimia nervosa. Biometrical model fitting, which corrected for the biased twin correlations of the ascertained group, was used to investigate the genetic and environmental risk factors contributing to the development of bulimia nervosa. The best-fitting model showed that individual variation was best explained by additive genetic influences (62%) and nonshared environmental influences (38%). The proportion of genetic variance affecting individual variation in the ascertained group and the random group was not found to be significantly different. In summary, it is suggested that it may not be necessary to supplement a randomly selected sample with an ascertained sample when investigating the liability to a low-prevalence psychiatric disorder if a continuous measure of that disorder is available.     

No association of the Arg51Gln and Leu72Met polymorphisms of the ghrelin gene with anorexia nervosa or bulimia nervosa

Genetic factors likely contribute to the biological vulnerability to anorexia nervosa (AN) and bulimia nervosa (BN). We investigated whether the Arg51Gln and/or the Leu72Met gene polymorphisms of the human ghrelin, a peptide involved in the regulation of eating behavior, were associated to AN and/or BN. Two-hundred-ninety-two Caucasian women (114 with BN, 59 with AN and 119 healthy controls) participated into the study. No significant differences were found in the frequencies of the Arg51Gln and the Leu72Met ghrelin gene variants among patients with AN or BN and healthy controls. Moreover, no significant differences emerged in eating-related phenotypic variables between patients carrying the Leu72Met genotype as compared to those with the Leu72Leu genotype. These results suggest that the Arg51Gln and the Leu72Met polymorphisms of the human ghrelin gene do not contribute to the genetic susceptibility to AN and BN.     

Effect of eating rate on binge size in Bulimia Nervosa

Bulimia Nervosa (BN) is an eating disorder characterized by recurrent episodes of binge eating. During binge eating episodes, patients often describe the rapid consumption of food, and laboratory studies have shown that during binges patients with BN eat faster than normal controls (NC), but the hypothesis that a rapid rate of eating contributes to the excessive intake of binge meals has not yet been experimentally tested. The aim of this study was to assess the effect of eating rate on binge size in BN, in order to determine whether binge size is mediated, in part, by rate of eating. Thirteen BN and 14 NC subjects were asked to binge eat a yogurt shake that was served at a fast rate (140 g/min) on one occasion and at a slow rate (70 g/min) on another. NC subjects consumed 169 g more when eating at the fast rate than when eating at the slow rate. In contrast, consumption rates failed to influence binge size in patients with BN (fast: 1205 g; slow: 1195 g). Consequently, there was a significant group by rate interaction. As expected, patients with BN consumed more overall than NC subjects (1200 g vs. 740 g). When instructed to binge in the eating laboratory, patients with BN ate equally large amounts of food at a slow rate as at a fast rate. NC subjects ate less at a slow rate. These findings indicate that in a structured laboratory meal paradigm binge size is not affected by rate of eating.     

A systematic review of the literature on family functioning across all eating disorder diagnoses in comparison to control families

The objectives of this review were to systematically identify and evaluate quantitative research comparing family functioning (a) in eating disorder families with control families, (b) in families with different eating disorder diagnoses (c) perceptions of different family members and (d) the relationship between family functioning and recovery. This adds to the findings of previous reviews of family functioning by including data from control families, the range of diagnoses, and focusing on recovery. Findings were considered in relation to models of family functioning.