Anoreksiya Nervoza’da Psikososyal Tedaviler

Abstract

Yüksek morbidite ve mortalitesine karşın anoreksiya nervozanın psikolojik tedavilerine yönelik araştırmalar sınırlı sayıdadır. Bu yazıda, anoreksiya nervozaya yönelik çeşitli psikososyal tedavi yöntemlerinin genel hatlarıyla tanıtılması ve bu yöntemlerin etkinliklerine dair randomize kontrollü çalışmaların güncel bir derlemesinin yapılması amaçlanmıştır. Derlenen araştırmalar, ergenler üzerinde yürütülen çalışmalar ve ergenlerle erişkinlerin birlikte olduğu çalışmalar olmak üzere iki ana başlık altında incelenmiş; diğer değişkenlerle ilgili hususlar ayrıca ele alınmıştır. 

Keywords

• Anoreksiya nervoza,psikiyatrik rehabilitasyon,psikososyal

Psychosocial Treatments in Anorexia Nervosa

Abstract

Despite its severe morbidity and mortality, studies regarding the psychosocial treatments of anorexia nervosa are limited in number. This paper aims to present the general outlines of various psychosocial interventions developed for the treatment of anorexia nervosa and to provide an up-to-date review of the randomized-controlled studies on the effectiveness of these approaches. Reviewed studies were classified by age spectrum of samples under two main headings: adolescents and mixed samples of adults and adolescents. Specific issues about other variables were then discussed separately.

Keywords

• Anorexia nervosa,psychiatric rehabilitation,psychosocial

References

1. Agras WS, Lock J, Brandt H, Bryson SW, Dodge E, Halmi KA et al. (2014) Comparison of 2 family therapies for adolescent anorexia nervosa: a randomized parallel trial. JAMA Psychiatry, 71:1279-1286.
2. Ball J ,Mitchell P (2004) A randomized controlled study of cognitive behavior therapy and behavioral family therapy for anorexia nervosa patients. Eat Disord, 12:303-314.
3. Beard H, Marlowe M ,Ryle A (1990) The management and treatment of personality-disordered patients: the use of sequential diagrammatic reformulation. Br J Psychiatry, 156:541-545.
4. Carter FA, Jordan J, McIntosh VV, Luty SE, McKenzie JM, Frampton CM et al. (2011) The long-term efficacy of three psychotherapies for anorexia nervosa: a randomized, controlled trial. Int J Eat Disord, 44:647-654.
5. Channon S, de Silva P, Hemsley D ,Perkins R (1989) A controlled trial of cognitive-behavioural and behavioural treatment of anorexia nervosa. Behav Res Ther, 27:529-535.
6. Crisp AH, Norton K, Gowers S, Halek C, Bowyer C, Yeldham D et al. (1991) A controlled study of the effect of therapies aimed at adolescent and family psychopathology in anorexia nervosa. Br J Psychiatry, 159:325-333.
7. Dalle Grave R, Calugi S, Conti M, Doll H ,Fairburn CG (2013) Inpatient cognitive behaviour therapy for anorexia nervosa: a randomized controlled trial. Psychother Psychosom, 82:390-398.
8. Dare C, Eisler I, Russell G, Treasure J ,Dodge L (2001) Psychological therapies for adults with anorexia nervosa: randomised controlled trial of out-patient treatments. Br J Psychiatry, 178:216-221.

9. Eisler I (2005) The empirical and theoretical base of family therapy and multiple family day therapy for adolescent anorexia nervosa. J Fam Ther, 27:104-131.
10. Eisler I, Dare C, Hodes M, Russell G, Dodge E ,Le Grange D (2000) Family therapy for adolescent anorexia nervosa: the results of a controlled comparison of two family interventions. J Child Psychol Psychiatry, 41:727-736.
11. Eisler I, Dare C, Russell GF, Szmukler G, le Grange D ,Dodge E (1997) Family and individual therapy in anorexia nervosa: a 5-year follow-up. Arch Gen Psychiatry, 54:1025-1030.
12. Espie J ,Eisler I (2015) Focus on anorexia nervosa: modern psychological treatment and guidelines for the adolescent patient. Adolesc Health Med Ther, 6:9-16.
13. Fichter MM, Quadflieg N ,Lindner S (2013) Internet-based relapse prevention for anorexia nervosa: nine- month follow-up. J Eat Disord, 1:23.
14. Geist R, Heinmaa M, Stephens D, Davis R ,Katzman DK (2000) Comparison of family therapy and family group psychoeducation in adolescents with anorexia nervosa. Can J Psychiatry, 45:173-178.
15. Godart N, Berthoz S, Curt F, Perdereau F, Rein Z, Wallier J et al. (2012) A randomized controlled trial of adjunctive family therapy and treatment as usual following inpatient treatment for anorexia nervosa adolescents. PLoS One, 7:e28249.
16. Gowers SG, Clark A, Roberts C, Griffiths A, Edwards V, Bryan C et al. (2007) Clinical effectiveness of treatments for anorexia nervosa in adolescents: randomised controlled trial. Br J Psychiatry, 191:427-435.
17. Guarda AS (2008) Treatment of anorexia nervosa: insights and obstacles. Physiol Behav, 94:113-120.
18. Hall A ,Crisp AH (1987) Brief psychotherapy in the treatment of anorexia nervosa. outcome at one year. Br J Psychiatry, 151:185-191.
19. Hay PP, Bacaltchuk J, Byrnes RT, Claudino AM, Ekmejian AA ,Yong PY (2003) Individual psychotherapy in the outpatient treatment of adults with anorexia nervosa. Cochrane Database Syst Rev, (4):CD003909.
20. Hudson JI, Hiripi E, Pope HG ,Kessler RC (2007) The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry, 61:348-358.
21. Kugu N, Akyuz G, Dogan O, Ersan E ,Izgic F (2006) The prevalence of eating disorders among university students and the relationship with some individual characteristics. Aust N Z J Psychiatry, 40:129-135.
22. Le Grange D, Eisler I, Dare C ,Russell GF (1992) Evaluation of family treatments in adolescent anorexia nervosa: a pilot study. Int J Eat Disord, 12:347-357.
23. Le Grange D, Accurso EC, Lock J, Agras S ,Bryson SW (2014a) Early weight gain predicts outcome in two treatments for adolescent anorexia nervosa. Int J Eat Disord, 47:124-129.
24. Le Grange D, Lock J, Accurso EC, Agras WS, Darcy A, Forsberg S et al. (2014b) Relapse from remission at two- to four-year follow-up in two treatments for adolescent anorexia nervosa. J Am Acad Child Adolesc Psychiatry, 53:1162-1167.
25. Le Grange D, Hughes EK, Court A, Yeo M, Crosby RD ,Sawyer SM (2016) Randomized clinical trial of parent-focused treatment and family-based treatment for adolescent anorexia nervosa. J Am Acad Child Adolesc Psychiatry, 55:683-692.
26. Lock J, Agras WS, Bryson S, Brandt H, Halmi KA, Kaye W et al. (2016) Does family-based treatment reduce the need for hospitalization in adolescent anorexia nervosa? Int J Eat Disord, 49:891-894.
27. Lock J, Agras WS, Bryson S ,Kraemer HC (2005) A comparison of short-and long-term family therapy for adolescent anorexia nervosa. J Am Acad Child Adolesc Psychiatry, 44:632-639.
28. Lock J, Le Grange D, Agras WS, Moye A, Bryson SW ,Jo B (2010) Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Arch Gen Psychiatry, 67:1025-1032.
29. Maner F (2001) Yeme bozuklukları. Psikiyatri Dünyası, 5:130-139.
30. Maner F ,Aydın A (2007) Yeme bozukluklarında bilişsel davranışçı tedavi. Psikiyatride Derlemeler, Olgular ve Varsayımlar, 1(3):23-36.
31. McIntosh VV, Bulik CM, McKenzie JM, Luty SE ,Jordan J (2000) Interpersonal psychotherapy for anorexia nervosa. Int J Eat Disord, 27:125-139.
32. McIntosh VV, Jordan J, Carter FA, Luty SE, McKenzie JM, Bulik CM et al. (2005) Three psychotherapies for anorexia nervosa: a randomized, controlled trial. Am J Psychiatry, 162:741-747.
33. McIntosh VV, Jordan J, Luty SE, Carter FA, McKenzie JM, Bulik CM et al. (2006) Specialist supportive clinical management for anorexia nervosa. Int J Eat Disord, 39:625-632.
34. Morgan H ,Hayward A (1988) Clinical assessment of anorexia nervosa: the Morgan-Russell outcome assessment schedule. Br J Psychiatry, 152:367-371.
35. Pike KM, Walsh BT, Vitousek K, Wilson GT ,Bauer J (2003) Cognitive behavior therapy in the posthospitalization treatment of anorexia nervosa. Am J Psychiatry, 160:2046-2049.
36. Rhodes P, Baillee A, Brown J ,Madden S (2008) Can parent-to-parent consultation improve the effectiveness of the Maudsley model of family-based treatment for anorexia nervosa? a randomized control trial. J Fam Ther, 30:96-108.
37. Robin AL, Siegel PT, Moye AW, Gilroy M, Dennis AB ,Sikand A (1999) A controlled comparison of family versus individual therapy for adolescents with anorexia nervosa. J Am Acad Child Adolesc Psychiatry, 38:1482-1489.
38. Russell GF, Szmukler GI, Dare C ,Eisler I (1987) An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Arch Gen Psychiatry, 44:1047-1056.
39. Schmidt U, Magill N, Renwick B, Keyes A, Kenyon M, Dejong H et al. (2015) The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC): Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) with specialist supportive clinical management (SSCM) in outpatients with broadly defined anorexia nervosa: a randomized controlled trial. J Consult Clin Psychol, 83:796-807.
40. Schmidt U, Oldershaw A, Jichi F, Sternheim L, Startup H, McIntosh V et al. (2012) Out-patient psychological therapies for adults with anorexia nervosa: randomised controlled trial. Br J Psychiatry, 201:392-399.
41. Schmidt U, Ryan EG, Bartholdy S, Renwick B, Keyes A, O'Hara C et al. (2016) Two-year follow-up of the MOSAIC trial: A multicenter randomized controlled trial comparing two psychological treatments in adult outpatients with broadly defined anorexia nervosa. Int J Eat Disord, 49:793-800.
42. Semiz M, Kavakçı Ö, Yağız A, Yontar G ,Kuğu N (2013) Sivas il merkezinde yeme bozukluklarının yaygınlığı ve eşlik eden psikiyatrik tanılar. Turk Psikiyatri Derg, 24:149-157.
43. Steinhausen HC (2002) The outcome of anorexia nervosa in the 20th century. Am J Psychiatry, 159:1284-1293.
44. Touyz S, Le Grange D, Lacey H, Hay P, Smith R, Maguire S et al. (2013) Treating severe and enduring anorexia nervosa: a randomized controlled trial. Psychol Med, 43:2501-2511.
45. Treasure J, Todd G, Brolly M, Tiller J, Nehmed A ,Denman F (1995) A pilot study of a randomised trial of cognitive analytical therapy vs educational behavioral therapy for adult anorexia nervosa. Behav Res Ther, 33:363-367.
46. Varchol L ,Cooper H (2009) Psychotherapy approaches for adolescents with eating disorders. Curr Opin Pediatr, 21:457-464.
47. Wallin U, Kronovall P ,Majewski M-L (2000) Body awareness therapy in teenage anorexia nervosa: outcome after 2 years. Eur Eat Disord Rev, 8:19-30.
48. Watson HJ ,Bulik CM (2013) Update on the treatment of anorexia nervosa: review of clinical trials, practice guidelines and emerging interventions. Psychol Med, 43:2477-2500.
49. Yeşilbursa D (1990) Lise öğrencilerinde anoreksiya nervoza-bulimiya sıklığı ve beden imgesi değerlendirilmesi (Uzmanlık tezi). İstanbul, Bakırköy Ruh ve Sinir Hastalıkları Hastanesi.
50. Zipfel S, Wild B, Groß G, Friederich H-C, Teufel M, Schellberg D et al. (2014) Focal psychodynamic therapy, cognitive behaviour therapy, and optimised treatment as usual in outpatients with anorexia nervosa (ANTOP study): randomised controlled trial. Lancet, 383:127-137.