Статья

Cognitive-behavioral therapy for adults with avoidant/restrictive food intake disorder

Jennifer J. ThomasDepartment of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USAKendra R. BeckerDepartment of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USALauren BreithauptDepartment of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USAHelen Burton MurrayDepartment of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USAJenny H. JoEating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USAMegan KuhnleEating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USAMelissa J. DreierEating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USAStephanie G. HarshmanDepartment of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USADanielle KahnEating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USAKristine HauserNeuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457-B, Boston, MA 02114, USAMeghan SlatteryNeuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457-B, Boston, MA 02114, USAMadhusmita MisraDepartment of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USAElizabeth A. LawsonDepartment of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USAKamryn T. EddyDepartment of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA

2021en

ABI

Аннотация

There are currently no evidence-based treatments for adults with avoidant/restrictive food intake disorder (ARFID). The purpose of this study was to evaluate the acceptability, feasibility, and proof-of-concept of cognitive-behavioral therapy for ARFID (CBT-AR) for adults. Males and females (ages 18–55 years) were offered 20-30 outpatient sessions of CBT-AR delivered by one of five therapists. Of 18 eligible adults offered CBT-AR, 15 chose to participate and 14 completed treatment. All patients endorsed high ratings of treatment credibility and expected improvement after the first session, and 93% of completers provided high ratings of satisfaction at the conclusion of treatment. Therapists rated the majority (80%) of patients as “much improved” or “very much improved.” Based on intent-to-treat analyses, ARFID severity on the Pica, ARFID, and Rumination Disorder Interview (PARDI) showed a large and significant decrease from pre- to post-treatment; and patients incorporated a mean of 18.0 novel foods. The underweight subgroup (n = 4) gained an average of 11.38 pounds, showing a large and significant increase in mean BMI from the underweight to the normal-weight range. At post-treatment, 47% of patients no longer met criteria for ARFID. To our knowledge, this is the first prospective treatment study of ARFID in adults. The findings of this study provide preliminary evidence of feasibility, acceptability, and proof-of-concept of CBT-AR for heterogeneous presentations of ARFID in adults. Randomized controlled trials are needed to confirm these findings. ClinicalTrials.gov Identifier: NCT02963220.

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Идентификаторы

DOI: 10.1016/j.jbct.2020.10.004

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