anorexia nervosa

神经性厌食症
  • 文章类型: Journal Article
    本文综述了饮食失调的药物管理的最新研究,包括神经性厌食症(AN),神经性贪食症(BN),暴饮暴食症(BED),和回避性/限制性食物摄入障碍。包括通过PubMed搜索获得的有关青年和成人的最新文献。美国精神病学协会指南,国家健康与护理卓越研究所指南,加拿大实践指南,和世界生物精神病学协会联合会指南也包括在内。一线建议集中在治疗上,因为饮食失调的药物管理证据仍然有限。一些有限的证据被发现用于抗精神病药,选择性5-羟色胺再摄取抑制剂和托吡酯用于BN,和兴奋剂和托吡酯用于床。需要进一步的药物试验来帮助成年人和年轻人出现复杂的饮食失调。
    This article reviews the latest research on pharmacological management of eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and avoidant/restrictive food intake disorder. Recent literature for both youth and adult populations obtained through a PubMed search was included. American Psychiatric Association guidelines, National Institute for Health and Care Excellence guidelines, Canadian practice guidelines, and World Federation of Societies of Biological Psychiatry guidelines were also included. First-line recommendations were focused on therapy because the evidence for medication management of eating disorders continues to be limited. Some limited evidence was found for antipsychotic use for AN, selective serotonin reuptake inhibitors and topiramate use for BN, and stimulant and topiramate use for BED. Further medication trials are needed to help with complex eating disorder presentations in adults and youth.
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  • 文章类型: Journal Article
    在这次审查中,作者提供了关于神经性厌食症(AN)在整个生命周期中的最新认识。专注于过去5年的重要文学作品,这篇综述总结了AN领域内DSM-5的最新更新,包括新的AN诊断:非典型厌食症。本综述涵盖的其他部分包括对整个发育范围内AN的流行病学理解的改进,已被确立为黄金标准的治疗方法以及最近在治疗中探索的新方向,以及AN的生物心理社会基础的最新进展。总之,尽管这篇综述捕捉到了该领域对AN的整体概念化的几个进步,治疗和诊断能力的几个关键领域仍然需要额外的关注和研究。
    In this review, the authors provide an update on the understanding of anorexia nervosa (AN) across the lifespan. Focusing on key pieces of literature from the past 5 years, this review summarizes recent updates to DSM-5 within the domain of AN, including the addition of a new AN diagnosis: atypical anorexia. Additional sections covered in this review include improvements in the epidemiological understanding of AN across the developmental spectrum, treatment approaches that have been established as gold standard as well as new directions recently explored in treatment, and recent advancements in the biopsychosocial underpinnings of AN. Altogether, although this review captures several advancements in the field\'s overall conceptualization of AN, several key areas of treatment and diagnostic capacity continue to require additional focus and research.
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  • 文章类型: Journal Article
    神经性厌食症(AN)是一种复杂的神经精神疾病。本系统综述综合了来自各种研究的证据,以评估和研究AN患者的基因多态性与心理和神经生物学因素之间的关联。
    跨PubMed的系统搜索,PsycINFO,Scopus,和WebofScience数据库,随着手动搜索,进行了。审查方案经PROSPERO(CRD42023452548)批准。在1,250篇文章中,11符合纳入标准。使用纽卡斯尔-渥太华量表(NOS)工具评估合格文章的质量。系统审查遵循PRISMA指南。
    5-羟色胺能系统,特别是5-HTTLPR多态性,始终与腹侧注意力网络中改变的连通性相关联,抑制控制受损,对AN的敏感性增加。5-HTTLPR多态性影响奖励处理,动机,推理,工作记忆,抑制,和AN患者的预后预测。多巴胺能系统,涉及像COMT这样的基因,DRD2、DRD3和DAT1调节奖励,动机,和决策。这些多巴胺能基因的遗传变异与AN患者的心理表现和临床严重程度有关。在人群中,BDNF基因的Val66Met多态性影响人格特征,饮食行为,和情绪反应。像OXTR这样的基因,TFAP2B,KCTD15与社会认知有关,情绪处理,身体形象问题,和AN患者的人格维度。
    多个基因与AN的易感和/或严重程度有关联。这种遗传因素有助于AN的复杂性,并导致其临床表现的更高多样性。因此,进行更广泛的研究以阐明神经性厌食症病理的潜在机制对于提高我们的认识和开发针对该疾病的有针对性的治疗干预措施至关重要.系统审查注册:[https://clinicaltrials.gov/],标识符[CRD42023452548]。
    UNASSIGNED: Anorexia nervosa (AN) is a complex neuropsychiatric disorder. This systematic review synthesizes evidence from diverse studies to assess and investigate the association between gene polymorphisms and psychological and neurobiological factors in patients with AN.
    UNASSIGNED: A systematic search across PubMed, PsycINFO, Scopus, and Web of Science databases, along with manual searching, was conducted. The review protocol was approved by PROSPERO (CRD42023452548). Out of 1,250 articles, 11 met the inclusion criteria. The quality of eligible articles was assessed using the Newcastle-Ottawa Scale (NOS) tool. The systematic review followed the PRISMA guidelines.
    UNASSIGNED: The serotoninergic system, particularly the 5-HTTLPR polymorphism, is consistently linked to altered connectivity in the ventral attention network, impaired inhibitory control, and increased susceptibility to AN. The 5-HTTLPR polymorphism affects reward processing, motivation, reasoning, working memory, inhibition, and outcome prediction in patients with AN. The dopaminergic system, involving genes like COMT, DRD2, DRD3, and DAT1, regulates reward, motivation, and decision-making. Genetic variations in these dopaminergic genes are associated with psychological manifestations and clinical severity in patients with AN. Across populations, the Val66Met polymorphism in the BDNF gene influences personality traits, eating behaviors, and emotional responses. Genes like OXTR, TFAP2B, and KCTD15 are linked to social cognition, emotional processing, body image concerns, and personality dimensions in patients with AN.
    UNASSIGNED: There was an association linking multiple genes to the susceptibly and/or severity of AN. This genetic factor contributes to the complexity of AN and leads to higher diversity of its clinical presentation. Therefore, conducting more extensive research to elucidate the underlying mechanisms of anorexia nervosa pathology is imperative for advancing our understanding and potentially developing targeted therapeutic interventions for the disorder.Systematic review registration: [https://clinicaltrials.gov/], identifier [CRD42023452548].
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  • 文章类型: Journal Article
    背景:NICE推荐用于治疗成人神经性厌食症(AN)的Maudsley模型(MANTRA)。然而,尽管如此,该方法仍相对研究不足。这项研究的目的是系统地更新有关使用MANTRA治疗饮食失调(ED)的研究证据。
    方法:使用的数据库是WebofScience,Scopus,和PsycInfo,包括2023年5月31日之前的研究。遵循PRISMA准则,和Cochrane工具用于评估偏倚风险。搜索的重点是确定已发表的文章,这些文章讨论了MANTRA作为ED治疗的组成部分的有用性,遵循PICO标准。
    结果:纳入了2011年至2023年期间的9项研究。研究结果表明,MANTRA可有效改善体重指数(BMI),饮食症状和情绪状态。与其他处理条件相比通常没有显著差异。解释本系统评价的局限性包括纳入研究的方法学质量和偏倚风险升高。
    结论:本综述是首次研究MANTRA的有效性。结果表明,MANTRA在解决关键临床变量方面已显示出与成人AN患者其他治疗方法相似的有效性。它已在不同的人群中使用(青少年,男性,住院病人)和格式(组,在线)然而,需要更多的研究来确定其有效性。
    BACKGROUND: Maudsley Model of Anorexia nervosa (AN) Treatment for Adults (MANTRA) is recommended by NICE for the treatment of adults with AN. However, despite this fact, the approach remains relatively understudied. The aim of this study was to systematically update the research evidence regarding the use of the MANTRA in the treatment of Eating Disorders (ED).
    METHODS: The databases used were Web of Science, Scopus, and PsycInfo, including studies up to 31 May 2023. PRISMA guidelines were followed, and Cochrane tools were used to assess the risk of bias. The search focused on identifying published articles that discussed the usefulness of MANTRA as a component of treatment for ED, following PICO criteria.
    RESULTS: Nine studies spanning the period from 2011 to 2023 were included. Findings suggested that MANTRA was effective in improving body mass index (BMI), eating symptomatology and emotional state. There were generally no significant differences compared to other treatment conditions. Limitations to interpreting this systematic review include the methodological quality of included studies and the elevated risk of bias.
    CONCLUSIONS: This review was the first to examine the effectiveness of MANTRA. The results indicate that MANTRA has shown effectiveness similar to other treatments for adults AN patients in addressing key clinical variables. It has been used in different populations (adolescents, males, inpatients) and formats (group, online) However, more research is needed to determine its effectiveness.
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  • 文章类型: Journal Article
    进食障碍(ED)是以危险的进食行为为特征的心理障碍,包括长期禁食和暴饮暴食。精神障碍合并症(例如,焦虑和抑郁),以及睡眠困难,是常见的,可能会干扰治疗反应。这项工作调查了睡眠质量,昼夜节律偏好,与健康对照(HC)相比,ED患者的睡眠障碍以及ED治疗对患者睡眠的影响。在Pubmed上进行文献检索,WebofScience,Medline,PsychInfo包括27项研究。进行了随机效应分析(样本进食障碍=711;样本健康对照=653),并根据ED亚组计算亚组分析:神经性厌食症,神经性贪食症,暴饮暴食症。全样本分析显示患者的生理和主观睡眠质量较差。亚组分析表明,仅在神经性厌食症中存在较差的生理睡眠。两项报告昼夜节律偏好和睡眠障碍的研究显示,患者的晚上偏好更高,患者和健康对照组之间的呼吸暂停患病率没有差异。分别。一些研究表明,专门的饮食失调治疗(例如,ED的认知行为疗法)可以改善患者的睡眠质量。尽管这些发现强调了ED患者与健康对照组相比睡眠较差,饮食失调中睡眠改变的潜在机制仍有待确定。
    Eating disorders (ED) are psychological disorders characterized by dangerous eating behaviours, including protracted fasting and binge eating. Mental disorders comorbidities (e.g., anxiety and depression), as well as sleep difficulties, are common and might interfere with treatment response. This work investigated sleep quality, circadian preferences, and sleep disorders in ED patients compared to healthy controls (HC) and the impact of ED treatment on patients\' sleep. A literature search on Pubmed, Web of Science, Medline, and PsychInfo included 27 studies. Random effect analyses were performed (sample eating disorders = 711; sample healthy controls = 653) and subgroup analyses were calculated based on the ED subgroups: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder. Whole sample analyses showed poorer physiological and subjective sleep quality in patients. Subgroup analyses showed that poorer physiological sleep was present only in anorexia nervosa. Two studies reporting circadian preferences and sleep disorders showed higher evening preference in patients and no differences in apnea prevalence between patients and healthy controls, respectively. Some studies suggested that specialized eating disorder treatments (e.g., Cognitive Behavioural Therapy for ED) can improve sleep quality in patients. Although these findings highlight poorer sleep in patients with ED compared to healthy controls, the mechanisms underlying sleep alterations in eating disorders remain to be identified.
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  • 文章类型: Journal Article
    系统评价的目的是综合有关进食障碍(ED)和非人际创伤事件(NTE)的文献,并巩固报告的ED患者NTE患病率。
    文献检索在Embase,PsycInfo,和PubMed。搜索的关键词是\"饮食失调,\"\"创伤\"和\"非人际关系,\"使用与NTE和ED相关的索引术语和免费搜索关键字。遵循PRISMA准则。使用Rayyan筛选相关研究。
    在定量合成中包含的16项研究中,确定了五种总体类型的NTE:事故,疾病,损伤,自然灾害和战争。研究结果为患有ED的患者与对照组相比,疾病和损伤更为普遍提供了初步证据。与对照组相比,在ED患者中,NTE的其余亚型并未显示出更高的患病率。研究结果还表明,与限制性神经性厌食症(AN)亚型相比,患有暴饮暴食/清除型神经性厌食症(AN)的非人际创伤事件的患病率更高。
    本系统综述提供了ED患者与NTE相关的先前发现的清晰综合。值得注意的是,许多研究没有考虑创伤发生在ED发作之前或之后,这可能会影响协会。此外,关于ED患者NTE的研究非常有限,需要更多的研究。
    UNASSIGNED: The purpose of the systematic review was to synthesize literature on eating disorders (ED) and non-interpersonal traumatic events (NTE) and consolidate the reported prevalence of NTE in patients with an ED.
    UNASSIGNED: The literature search was performed in Embase, PsycInfo, and PubMed. The keywords in the search were \"eating disorder,\" \"trauma\" and \"non-interpersonal,\" using index-terms and free-search keywords related to NTE and ED. The PRISMA guidelines were followed. Relevant studies were screened using Rayyan.
    UNASSIGNED: Of the 16 studies included in the quantitative synthesis, five overall types of NTE were identified: accidents, illness, injury, natural disaster and war. Findings provided tentative evidence for illness and injury being more prevalent in patients suffering from an ED compared to controls. The remaining subtypes of NTE did not show a higher prevalence in patients with an ED when compared to controls. Findings also suggest that those with binge/purge subtype of anorexia nervosa (AN) had a higher prevalence of non-interpersonal traumatic events compared to the restrictive subtype of AN.
    UNASSIGNED: This systematic review provided a clear synthesis of previous findings related to NTE among patients with an ED. Noteworthy, is that many studies do not take into account if the trauma happened prior or after to ED onset, which may affect the association. Furthermore, the body of research on NTE in patients with ED is exceedingly limited, and more research is needed.
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  • 文章类型: Journal Article
    本综述的目的是解决四个问题:1)不同饮食失调(ED)诊断的患者之间的家庭功能或家庭环境是否存在差异?2)不同家庭成员之间对家庭功能或家庭环境的看法是否存在差异?3)家庭功能或家庭环境是否与ED症状有关?4)家庭功能或家庭环境是否因ED治疗而发生变化?4a)如果是,这是否影响ED治疗结果?尽管大多数研究发现ED诊断组之间没有差异,那些在有暴饮暴食/清除症状的人中发现的家庭功能通常比患有限制性神经性厌食症亚型的人差。发现家庭成员对家庭功能的看法存在差异,患者通常报告的功能比他们的父母差。通常发现较差的家庭功能与较差的ED症状有关。治疗方法的多样性和对结果的不同评估使得在某种程度上不清楚ED治疗是否持续改善家庭功能。需要更多关于家庭功能和ED的研究,特别是在研究不足的群体中,如男性,以及除神经性厌食症或神经性贪食症以外的ED诊断。
    The purpose of the current review was to address four questions: 1) Are there differences in family functioning or family environment among patients with different eating disorder (ED) diagnoses? 2) Are there differences in the perception of family functioning or family environment among different family members? 3) Is family functioning or family environment related to ED symptomatology? 4) Does family functioning or family environment change as a result of ED treatment? and 4a) If so, does this impact ED treatment outcome? Although most studies found no differences among ED diagnostic groups, those that did generally found worse family functioning among those with binge/purge symptoms than among those with the restricting subtype of anorexia nervosa. Differences in perceptions of family functioning among family members were found, with patients generally reporting worse functioning than their parents. Worse family functioning was generally found to be related to worse ED symptoms. The variety of treatment approaches and different assessments of outcome made it somewhat unclear whether family functioning consistently improves with ED treatment. More research is needed on family functioning and EDs, particularly in understudied groups such as males, and those with ED diagnoses other than anorexia nervosa or bulimia nervosa.
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  • 文章类型: Journal Article
    背景:进食障碍(ED)对健康构成重大风险,尤其是在没有早期诊断的时候。几年来,人们对ED和口腔健康进行了广泛的研究,现在很清楚特定的口腔表现与这些疾病之间存在相关性。虽然这些口腔体征可能有助于ED的早期诊断,他们的识别和最终建立的相关性目前严重限于临床医生的经验。本系统综述严格审查现有文献,提供与ED相关的口腔牙齿表现的最新概述。
    方法:MEDLINE(通过PubMed),WebofScience,Scopus,搜索了灰色文献,并使用Rayyan软件对相关流行病学比较研究进行筛选。关于口腔牙科结果的研究没有受到任何限制,包括所有医学诊断的ED。使用用于横断面研究的AXIS评估工具评估研究的质量。
    结果:在3990项研究中,32符合资格标准并包括在合成中。确定的饮食失调包括神经性厌食症,神经性贪食症和/或进食障碍未另作说明,主要在女性受试者中,主要来自欧洲。评估的口腔牙齿结果包括牙齿侵蚀,龋齿,唾液评估,卫生-牙周参数,和粘膜组织外观。牙龈衰退时,与侵蚀的关联得到证实,牙本质过敏,唾液流量阈值和与口腔病理学相关的方面正从新出现的证据中获得越来越多的支持.
    结论:这一趋势强调了完整的口内检查对检测可能表明ED发作的显著口牙征象的关键作用。
    这篇文章是对现有研究的回顾,这些研究探讨了饮食失调和口腔健康问题之间的联系。它发现有饮食失调的人,包括神经性厌食症和神经性贪食症,可能会遇到牙齿问题,如牙齿侵蚀,空腔,并改变了唾液的产生。审查结果强调了牙科护理提供者尽早认识到这些迹象的重要性,并建议对牙科专业人员进行更好的培训。通过这样做,它们可以帮助更快地诊断饮食失调并建议适当的治疗。这种方法旨在通过解决口腔健康问题和潜在的饮食失调来改善患者的整体健康状况。使患者和医疗团队意识到口腔健康和饮食失调之间的相互联系至关重要。
    BACKGROUND: Eating disorders (EDs) pose a significant risk to health, especially when not diagnosed early. For several years EDs and oral health has been extensively studied, and now it is quite clear the existence of a correlation between specific oral manifestations and these disorders. While these oral signs could potentially aid early diagnosis of EDs, their identification and the eventual establishment of a correlation is currently heavily limited to the clinician\'s experience. The present systematic review critically examines existing literature, offering an updated overview of oro-dental manifestations associated with EDs.
    METHODS: MEDLINE (via PubMed), Web of Science, Scopus, and grey literature were searched, and relevant epidemiological comparative studies were screened using the Rayyan software. No limitations have been imposed on the research regarding oro-dental outcomes, encompassing all medically diagnosed EDs. The quality of the studies was valuated using AXIS appraisal tool for cross-sectional studies.
    RESULTS: Out of 3990 studies, 32 fulfilled the eligibility criteria and were included in the synthesis. The identified eating disorders include Anorexia Nervosa, Bulimia Nervosa and/or Eating Disorders Not Otherwise Specified, predominantly among female subjects, primarily originating from Europe. The evaluated oro-dental outcomes include dental erosion, caries, saliva assessment, hygiene-periodontal parameters, and mucosal tissue appearance. The association with erosion is confirmed while gingival recession, dentinal hypersensitivity, salivary flow thresholds and aspects relating to oral pathology are receiving increasing support from emerging evidence.
    CONCLUSIONS: This trend emphasizes the critical role of the complete intraoral examination to detect significant oro-dental signs that may indicate the onset of an ED.
    The article is a review of existing studies that explores the link between eating disorders and oral health issues. It found that people with eating disorders, including anorexia nervosa and bulimia nervosa, may experience dental problems such as tooth erosion, cavities, and altered saliva production. The review findings emphasize the importance of dental care providers recognizing these signs early and suggests better training for dental professionals. By doing so, they can help diagnose eating disorders sooner and recommend appropriate treatment. This approach aims to improve patients’ overall wellbeing by addressing both the oral health issues and the underlying eating disorders, making it essential for patients and medical teams to be aware of the interconnectedness between oral health and eating disorders.
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  • 文章类型: Journal Article
    背景:神经性厌食症住院患者的体重指数(BMI)的变化尚未在年龄范围内进行分析。据报道,在15岁及以下的青少年住院患者中,BMI与年龄之间呈正相关,在15至18岁时趋于稳定。年龄和性别标准化的BMI(标准差分数,在这些8至18岁的住院患者中,SDSs)与年龄呈负相关。
    方法:当前回顾性研究的目的有三个方面:第一,为了确认BMI之间的关系,在更大的样本中,青少年住院患者的BMI-SDS和年龄;第二,为了系统地评估BMI之间的关系,BMI-SDS,转诊时成人住院患者的身高-SDS和年龄;第三,评估身高-SDS和年龄以评估发育迟缓。
    结果:我们包括2014年至2021年期间接受住院治疗的1001名女孩(12-17.9岁)和1371名妇女(18-73岁)。青少年入院时的平均BMI为14.95kg/m2(SD=1.43;范围10.67-18.47),成年人为14.63kg/m2(SD=2.02;范围8.28-18.47)。青少年患者中没有一个,但20名成年人的BMI值非常低,低于10kg/m2。青少年在年龄和BMI之间显示出较小但显着的正相关(r=0.12;p=2.4×10-4)。在成年人中,BMI与年龄无关(r=-0.03;p=0.3)。在青少年中,BMI-SDS与年龄呈负相关,而在成年人中,BMI-SDS与年龄呈负相关(r=-0.35;p<0.001,r=-0.09;p=0.001)。所有患者的曲线拟合分析表明,年龄与BMI-SDS之间存在二次(年龄×年龄)关系。成人(r=0.1;p<0.001)和青少年(r=0.09p=0.005)患者的身高与BMI呈正相关,我们没有发现发育迟缓的证据。
    结论:结论:住院患者的BMI在整个年龄段似乎相对稳定,平均值在14~15kg/m2之间.在年轻患者中,BMI值最初随着年龄的增长而增加,在18至23岁之间下降,然后随着年龄的增长而缓慢下降。
    BACKGROUND: The variation in body mass index (BMI) of inpatients with anorexia nervosa has not been analyzed across the age span. A positive correlation between BMI and age has been reported in adolescent inpatients aged 15 years and younger that levels off at 15 to 18 years. BMIs standardized for age and sex (standard deviation scores, SDSs) were negatively correlated with age in these inpatients aged 8 to 18 years.
    METHODS: The aims of the current retrospective study were threefold: first, to confirm the relationships of BMI, BMI-SDS and age in adolescent inpatients in a larger sample; second, to systematically assess the relationship of BMI, BMI-SDS, body height-SDS and age in adult inpatients at the time of referral; and third, to assess body height-SDSs and age to evaluate stunting.
    RESULTS: We included 1001 girls (aged 12-17.9 years) and 1371 women (aged 18-73 years) admitted to inpatient treatment between 2014 and 2021. Mean BMI at admission was 14.95 kg/m2 (SD = 1.43; range 10.67-18.47) in adolescents and 14.63 kg/m2 (SD = 2.02; range 8.28-18.47) in adults. None of the adolescent patients but 20 adults had very low BMI values below 10 kg/m2. Adolescents showed a small but significant positive correlation between age and BMI (r = 0.12; p = 2.4 × 10-4). In adults, BMI was not correlated with age (r = -0.03; p = 0.3). BMI-SDSs was negatively correlated with age in adolescents and less so in adults (r = -0.35; p < 0.001 and r = -0.09; p = 0.001). Curve fit analyses for all patients indicated that there was a quadratic (age × age) relationship between age and BMI-SDS. Height correlated positively with BMI in adult (r = 0.1; p < 0.001) and adolescent (r = 0.09 p = 0.005) patients and we detected no evidence for stunting.
    CONCLUSIONS: In conclusion, the BMI of inpatients seems to be relatively stable across the age span with mean values between 14 and 15 kg/m2. BMI values initially increase with age in younger patients, drop between ages 18 and 23 and then slowly decline with age.
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  • 文章类型: Journal Article
    目的:进食障碍(ED)是主要的公共卫生负担。越来越多,研究表明,心理健康(MH)领域未能提高治疗的有效性,必须考虑替代护理模式。精准心理健康(PMH)旨在根据个人需求定制治疗方法,并依赖于对精神疾病的神经生物学和生理基础的全面了解。
    方法:在这篇叙述性综述中,回顾并总结了已发表的文献,重点是针对ED的PMH策略的生物学应用。
    结果:本综述共保留了39篇文章,涵盖了与PMH相关的各种主题。许多具有PMH适用性的生物标记的研究集中在神经性厌食症上。尽管已经确定了各种潜在的PMH研究应用,审查未能发现任何实施常规ED实践的证据.
    结论:尽管PMH在ED治疗中的生物学应用具有理论价值,缺乏标准实践的临床应用。有必要进一步投资于寻求识别生物学标志物和研究疾病的神经生物学基础的研究,以期靶向和开发可以更好地适应患者个性化需求的治疗方法。
    OBJECTIVE: Eating disorders (EDs) represent a major public health burden. Increasingly, studies suggest mental health (MH) fields are failing to improve the effectiveness of treatments and that alternative models of care must be considered. Precision mental health (PMH) seeks to tailor treatment to individual needs and relies on a comprehensive understanding of the neurobiological and physiological underpinnings of mental illness.
    METHODS: In this narrative review, published literature with focus on biological application of PMH strategies for EDs is reviewed and summarised.
    RESULTS: A total of 39 articles were retained for the review covering a variety of themes with relevance to PMH. Many studies of biological markers with PMH applicability focused on anorexia nervosa. Although a variety of potential PMH research applications were identified, the review failed to identify any evidence of implementation into routine ED practice.
    CONCLUSIONS: Despite the theoretical merit of biological application of PMH in ED treatment, clinical applications for standard practice are lacking. There is a need to invest further in studies that seek to identify biological markers and investigate neurobiological underpinnings of disease in hopes of targeting and developing treatments that can be better tailored to the individualised needs of patients.
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