同时自控经颅直流电刺激和注意力偏差修正训练治疗暴饮暴食症:可行性随机假对照试验。

IF 3.9 3区 医学 Q1 PSYCHIATRY
BJPsych Open Pub Date : 2024-06-06 DOI:10.1192/bjo.2024.54
Michaela Flynn, Iain C Campbell, Ulrike Schmidt
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引用次数: 0

摘要

背景:暴饮暴食症(BED)是一种常见的致残性疾病,通常伴有多种精神病和肥胖相关的并发症。基于证据的治疗要么需要大量资源(心理治疗),要么有副作用(药物治疗):这些治疗仅能缓解约 50%的病例。目的:这项随机假对照试验旨在评估在家自控经颅直流电刺激(tDCS)和注意力偏差修正训练(ABMT)对暴食症成人患者的可行性、可接受性和初步疗效:方法:82 名患有暴食症的参与者被随机分配到真正的经颅直流电刺激与 ABMT、假经颅直流电刺激与 ABMT、仅 ABMT 或候补对照组。tDCS(2毫安,20分钟)采用双侧(阳极右侧/阴极左侧)蒙太奇疗法,针对背外侧前额叶皮层进行自我管理。结果在基线、治疗后和 6 周随访时进行评估:结果:超过了预先设定的可行性标准(招募人数≥80人,保留率≥75%),治疗完成率很高(98.7%)。与候补对照组相比,所有干预措施都减少了基线和随访期间的暴饮暴食发作、饮食失调症状和相关心理病理现象(变化分数的组间效应大小为中到大)。与对照组相比,真实tDCS与ABMT的变化分数的中小规模效应更有利,这表明verum干预产生了更好的结果:采用 ABMT 的居家自控 tDCS 是可行且可接受的,初步疗效数据也很有希望。这种方法可以成为暴饮暴食症既有疗法的一种有用且可扩展的替代或辅助疗法。可以而且应该继续进行确证试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Concurrent self-administered transcranial direct current stimulation and attention bias modification training in binge eating disorder: feasibility randomised sham-controlled trial.

Background: Binge eating disorder (BED) is a common and disabling condition, typically presenting with multiple psychiatric and obesity-related comorbidities. Evidence-based treatments are either resource-intensive (psychotherapies) or have side-effects (medications): these achieve remission in around 50% of cases. Novel treatments are needed.

Aims: This randomised sham-controlled trial aimed to assess feasibility, acceptability and preliminary efficacy of at-home, self-administered transcranial direct current stimulation (tDCS) and attention bias modification training (ABMT) in adults with binge eating disorder.

Method: Eighty-two participants with binge eating disorder were randomly allocated to real tDCS with ABMT, sham tDCS with ABMT, ABMT only or waitlist control. Intervention groups received ten sessions of their allocated treatment over 2-3 weeks. tDCS (2 mA, 20 min) was self-administered using a bilateral (anode right/cathode left) montage targeting the dorsolateral prefrontal cortex. Outcomes were assessed at baseline, post-treatment and 6-week follow-up.

Results: Prespecified feasibility criteria (recruitment ≥80 participants and retention rate ≥75%) were exceeded, and treatment completion rates were high (98.7%). All interventions reduced binge eating episodes, eating disorder symptoms and related psychopathology between baseline and follow-up, relative to waitlist control (medium-to-large between-group effect sizes for change scores). Small-to-medium effect sizes for change scores favoured real tDCS with ABMT versus comparators, suggesting the verum intervention produces superior outcomes.

Conclusions: At-home, self-administered tDCS with ABMT is feasible and acceptable, and preliminary data on efficacy are promising. This approach could be a useful and scalable alternative or adjunct to established treatments for binge eating disorder. Confirmatory trials can, and should, be pursued.

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来源期刊
BJPsych Open
BJPsych Open Medicine-Psychiatry and Mental Health
CiteScore
6.30
自引率
3.70%
发文量
610
审稿时长
16 weeks
期刊介绍: Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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