Background and objectives

No treatment for adult anorexia nervosa (AN) has shown sufficient effectiveness or superiority to other treatments. Overcontrol has been suggested as a viable mechanism to target in the treatment of patients with AN. Radically open dialectical behavior therapy (RO DBT) is developed for disorders related to maladaptive overcontrol. Our objective was to evaluate the outcome of RO DBT for AN in a clinical outpatient setting.

Methods

Thirteen adult female patients with mild to moderate AN provided written consent and entered a multiple baseline single-case experimental design study. Median age at eating disorder (ED) onset was 15 years and the median duration of the ED was 10 years. Individual changes were assessed weekly during a baseline phase (A) of four to six weeks, and during the subsequent 40-week RO DBT phase (B). Additional assessments were conducted before and after treatment, and at a six-month follow-up. Primary outcome was ED psychopathology. Secondary outcomes were psychosocial impairment, quality of life, social connectedness, and adaptive control strategies.

Results

Eight patients (62%) completed treatment. All completers were in full remission after treatment, with BMI ≥18.5 kg/m² and ED psychopathology within one standard deviation of the community mean. Improvements occurred after introducing RO DBT, not during baseline.

Limitations

Participants were female with mild to moderate AN, limiting generalizability to severe AN or males.

Conclusions

The study provides preliminary support for using RO DBT in adult outpatients with AN and overcontrol. Further studies should replicate these findings.

中文翻译：

---

神经性厌食症的彻底开放辩证行为疗法：一项跨越 13 例的多基线单例实验设计研究

背景和目标

成人神经性厌食症 (AN) 的治疗没有显示出足够的有效性或优于其他治疗。过度控制被认为是治疗 AN 患者的一种可行机制。完全开放的辩证行为疗法 (RO DBT) 是针对与适应不良过度控制相关的疾病而开发的。我们的目标是在临床门诊环境中评估 RO DBT 治疗 AN 的结果。

方法

13 名患有轻度至中度 AN 的成年女性患者提供了书面同意并进入了多基线单病例实验设计研究。进食障碍 (ED) 发病的中位年龄为 15 岁，ED 的中位持续时间为 10 年。在 4 到 6 周的基线阶段 (A) 和随后的 40 周 RO DBT 阶段 (B) 中，每周评估个体变化。在治疗前后以及六个月的随访中进行了额外的评估。主要结果是 ED 精神病理学。次要结果是社会心理障碍、生活质量、社会联系和适应性控制策略。

结果

8 名患者 (62%) 完成了治疗。所有完成者在治疗后均完全缓解，BMI ≥ 18.5 kg/m ²且 ED 精神病理学在社区平均值的一个标准偏差内。引入 RO DBT 后发生了改善，而不是在基线期间。

限制

参与者是患有轻度至中度 AN 的女性，限制了对重度 AN 或男性的普遍性。

结论

该研究为在患有 AN 和过度控制的成人门诊患者中使用 RO DBT 提供了初步支持。进一步的研究应该重复这些发现。