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Psychother Psychosom Med Psychol 2015; 65(01): 20-24
DOI: 10.1055/s-0034-1394410
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Gibt es spezifische Wirkfaktoren in der Psychotherapie der Anorexia nervosa?

Are there Specific Factors in the Psychotherapy of Anorexia nervosa?
Stephan Zipfel
1   Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
,
Gaby Resmark
1   Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
› Author Affiliations
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Publication History

eingereicht 06 October 2014

akzeptiert 09 October 2014

Publication Date:
16 January 2015 (online)

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Zusammenfassung

Die vorliegende Literatursichtung untersucht die Frage nach der Differenzierung von allgemeinen und spezifischen Wirkfaktoren bei der Psychotherapie der Anorexia nervosa. In den vergangenen 10 Jahren haben sich verschiedene Forschungstendenzen gezeigt. Zum einen werden Subdifferenzierungen von neuen Therapieformen aus verschiedenen therapeutischen Schulen propagiert (u. a. CBT-E, FPT), zum anderen werden generische, eher an den Bedürfnissen der Patienten orientierte Behandlungsmanuale publiziert (u. a. SSCM, TTM). Auf einem dritten Weg werden aktuell Therapiemanuale für besondere Subgruppen entwickelt, bspw. für chronische Patientinnen mit Anorexia nervosa oder familienbasierte Manuale für Adoleszente. Eine ganz andere Richtung verfolgen Ansätze, die auf neuropsychologischen Modellen und Defiziten bei Anorexia nervosa basieren. Insgesamt stimmen die Ergebnisse der aktuellen Studien eher optimistisch, dennoch gibt es keinen wirklichen Sieger, das Rennen ist offen!

Abstract

The present literature review examines the question of how general and specific factors can be differentiated in the psychotherapy of anorexia nervosa. Over the past 10 years different research trends have appeared. On the one hand subclassifications of new therapy approaches from several schools of therapy have been propagated (e. g. CBT-E, FPT), on the other hand generic treatment manuals have been published that are rather adapted to patients needs (e. g. SSCM, TTM). On a third way, currently therapy manuals for special subgroups have been developed, e. g. for chronic patients with anorexia nervosa or family-based manuals for adolescents. A completely different direction follows those approaches that are based on neuropsychological models and deficits in anorexia nervosa. Overall, the results of current studies have been promising, however, there has not been a winner yet, the race is still open!

Schlüsselwörter

Psychotherapie - Wirkfaktoren - evidenzbasierte Behandlung - Anorexia nervosa - Essstörungen

Keywords

psychotherapy - factors - evidence-based treatment - anorexia nervosa - eating disorders
 

  • Literatur

  • 1 Batra A, Buchkremer G, Dedner C et al. Psychotherapie. In: Klein HE, Pajonk FGB. Hrsg Facharztprüfung Psychiatrie und Psychotherapie. Stuttgart: Thieme; 2011: 158-183
    Article in Thieme ConnectGoogle Scholar
  • 2 Grawe K, Donati R, Bernauer F. Psychotherapie im Wandel. Von der Konfession zur Profession. Göttingen: Hogrefe; 1994
    Google Scholar
  • 3 Bulik CM, Berkman ND, Brownley KA et al. Anorexia nervosa treatment: a systematic review of randomized controlled trials. Int J Eat Disord 2007; 40: 310-320
    CrossrefPubMedGoogle Scholar
  • 4 Hay PPJ, Bacaltchuk J, Byrnes RT et al. Individual psychotherapy in the outpatient treatment of adults with anorexia nervosa (review), 2nd edn. Cochrane Database Syst Rev 2008; 1 CD003909
    PubMedGoogle Scholar
  • 5 Treasure J, Claudino AM, Zucker N. Eating disorders. Lancet 2010; 375: 583-593
    CrossrefPubMedGoogle Scholar
  • 6 Watson HJ, Bulik CM. Update on the treatment of anorexia nervosa: review of clinical trials, practice guidelines and emerging interventions. Psychol Med 2013; 43: 2477-2500
    CrossrefPubMedGoogle Scholar
  • 7 McIntosh VV, Jordan J, Carter FA et al. Three psychotherapies for anorexia nervosa: a randomized, controlled trial. Am J Psychiatry 2005; 162: 741-747
    CrossrefPubMedGoogle Scholar
  • 8 McIntosh VV, Jordan J, Luty SE et al. Specialist supportive clinical management for anorexia nervosa. Int J Eat Disord 2006; 39: 625-632
    CrossrefPubMedGoogle Scholar
  • 9 Carter FA, Jordan J, McIntosh VV et al. The long-term efficacy of three psychotherapies for anorexia nervosa: a randomized, controlled trial. In J Eat Disord 2011; 44: 647-654
    PubMedGoogle Scholar
  • 10 Schmidt U, Oldershaw A, Jichi F et al. Out-patient psychological therapies for adults with anorexia nervosa: randomised controlled trial. Br J Psychiatry 2012; 201: 392-399
    CrossrefPubMedGoogle Scholar
  • 11 Touyz S, Le Grange D, Lacey H et al. Treating severe and enduring anorexia nervosa: a randomized controlled trial. Psychol Med 2013; 43: 2501-2511
    CrossrefPubMedGoogle Scholar
  • 12 Wild B, Friederich HC, Gross G et al. The ANTOP study: focal psychodynamic psychotherapy, cognitive-behavioural therapy, and treatment-as-usual in outpatients with anorexia nervosa – a randomized controlled trial. Trials 2009; 10: 23 DOI: 10.1186/1745-6215-10-23.
    CrossrefPubMedGoogle Scholar
  • 13 Zipfel S, Wild B, Groß G et al. Focal psychodynamic therapy, cognitive behaviour therapy, and optimised treatment as usual in outpatients with anorexia nervosa (ANTOP study): randomised controlled trial. Lancet 2014; 383: 127-137
    CrossrefPubMedGoogle Scholar
  • 14 Fairburn CG. Kognitive Verhaltenstherapie und Essstörungen. Stuttgart: Schattauer; 2012
    Google Scholar
  • 15 Rießen I, Groß G, Zipfel S. Ambulante manualisierte Verhaltenstherapie bei Anorexia nervosa – Erfahrungsbericht aus der Supervision. Psychotherapeut 2010; 6: 496-502
    PubMedGoogle Scholar
  • 16 Schauenburg H, Friederich HC, Wild B et al. Focal psychodynamic psychotherapy of anorexia nervosa. Psychotherapeut 2009; 54: 270-280
    CrossrefPubMedGoogle Scholar
  • 17 Friederich HC, Herzog W, Wild B et al. Anorexia nervosa. Fokale psychodynamische Psychotherapie. Göttingen: Hogrefe; 2014
    Google Scholar
  • 18 Herpertz S, Herpertz-Dahlmann B, Fichter M et al Hrsg S3-Leitlinie Diagnostik und Behandlung der Essstörungen. Berlin: Springer; 2011
    CrossrefGoogle Scholar
  • 19 National Institute for Clinical Excellence (NICE). Eating disorders. Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. http://www.nice.org.uk/nicemedia/pdf/cg009niceguidance.pdf 2004
    PubMedGoogle Scholar
  • 20 Lock J, Le Grange D, Agras WS et al. Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Arch Gen Psychiatry 2010; 67: 1025-1032
    CrossrefPubMedGoogle Scholar
  • 21 Agras WS, Lock J, Brandt H et al. Comparison of 2 family therapies for adolescent anorexia nervosa. A randomized parallel trial. JAMA Psychiatry 2014; Epub ahead of print
    PubMedGoogle Scholar
  • 22 Herpertz-Dahlmann B, Schwarte R, Krei M et al. Day-patient treatment after short inpatient care versus continued inpatient treatment in adolescents with anorexia nervosa (ANDI): a multicentre, randomized, open-label, non-inferiority trial. Lancet 2014; 383: 1222-1229
    CrossrefPubMedGoogle Scholar
  • 23 Giel K, Leehr E, Becker S et al. Rückfallprophylaxe bei Anorexia nervosa. Psychother Psych Med 2013; 63: 290-295
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Poulsen S, Lunn S, Daniel SIF et al. A randomized controlled trial of psychoanalytic psychotherapy or cognitive-behavioral therapy for bulimia nervosa. Am J Psychiatry 2014; 171: 109-116
    CrossrefPubMedGoogle Scholar
  • 25 Touyz S, Le Grange D, Lacey H et al. Treating severe and enduring anorexia nervosa: a randomized controlled trial. Psychol Med 2013; 43: 2501-2511
    CrossrefPubMedGoogle Scholar
  • 26 Robinson P, Barrett B, Bateman A et al. Study protocol for a randomized controlled trial of mentalization based therapy against specialist supportive clinical management in patients with both eating disorders and symptoms of borderline personality disorder. BMC Psychiatry 2014; 14: 51 DOI: 10.1186/1471-244X-14-51.
    CrossrefPubMedGoogle Scholar
  • 27 Brauhardt A, de Zwaan M, Hilbert A. The therapeutic process in psychological treatments for eating disorders: a systematic review. Int J Eat disord 2014; 47: 565-584
    CrossrefPubMedGoogle Scholar
  • 28 Orlinsky DE, Rønnestad MH, Willutzki U. Fifty years of psychotherapy process-outcome research: continuity and change. In: Lambert MJ. (ed.). Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change. 5th ed. New York: Wiley; 2004: 307-389
    Google Scholar
  • 29 Mander J, Teufel M, Keifenheim K et al. Stages of change, treatment outcome and therapeutic alliance in adult inpatients with chronic anorexia nervosa. BMC Psychiatry 2013; 13: 111 DOI: 10.1186/1471-244X-13-111.
    CrossrefPubMedGoogle Scholar
  • 30 Keifenheim KE, Becker S, Mander J et al. Motivational Interviewing – Hintergründe, Methode, Möglichkeiten. Psychother Psych Med 2013; 63: 150-160
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Miller W, Rollnick S. Motivational Interviewing. Preparing people to change addictive behaviour. New York: Guilford Press; 1991
    Google Scholar
  • 32 Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983; 51: 390-395
    Google Scholar