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雑誌文献

精神医学52巻9号

2010年09月発行

文献概要

研究と報告

摂食障害患者の変化への段階と早期治療脱落

著者: 山田恒1 永田利彦1 吉村知穂1 中島豪紀1 切池信夫1

所属機関: 1大阪市立大学大学院医学研究科神経精神医学

ページ範囲:P.853 - P.861

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抄録

 摂食障害患者の治療意欲と早期治療脱落の関係について検討した。対象は,初診時に摂食障害と診断され同意を得られた女性患者152例で,神経性食思不振症(AN)61例,神経性過食症(BN)81例,特定不能の摂食障害(EDNOS)10例にthe stage of change questionnaire日本語版を用いて変化への段階を評価した。64例(42.1%)が通院5回以下で治療を中断し,BN群の脱落率が53.1%と高かった。変化への段階のうち,熟考段階では自己評価の低さが,行動段階ではやせ願望,過食衝動,内界への気づきが脱落と関連している可能性が示され,個々の患者の治療意欲の程度に合わせた対応の必要性が示された。

参考文献

1) American Psychiatric Association:Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision DSM-Ⅳ-TR. American Psychiatric Association, Washington, D.C., 2000
2) Blake W, Turnbull S, Treasure J:Stages and Processes of Change in Eating Disorders:Implications for Therapy. Clin Psychol Psychother 4:186-191, 1997
3) Di Pietro G, Valoroso L, Fichele M, et al:What happens to eating disorder outpatients who withdrew from therapy? Eat Weight Disord 7:298-303, 2002
4) Fairburn CG, Cooper Z, Shafran R:Cognitive behaviour therapy for eating disorders:A "transdiagnostic" theory and treatment. Behav Res Ther 41:509-528, 2003
5) Fassino S, Abbate-Daga G, Piero A, et al:Dropout from brief psychotherapy within a combination treatment in bulimia nervosa:Role of personality and anger. Psychother Psychosom 72:203-210, 2003
6) Garner DM, Olmstead MP, Polivy J:Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int J Eat Disord 2:15-34, 1983
7) Kahn C, Pike KM:In search of predictors of dropout from inpatient treatment for anorexia nervosa. Int J Eat Disord 30:237-244, 2001
8) McConnaughy EA, DiClement CC, Prochaska JO, et al:Stage of change in psychotherapy:A follow-up report. Psychother 26:494-503, 1989
9) McConnaughy EA, Prochaska JO, Velicer WF:Stages of change in psychotherapy:Measurement of sample profiles. Psychotherapy:Theory, Research and Practice 20:368-375, 1983
10) Miller WR, Rollnick S:Motivational Interviewing:Preparing people to change addictive behavior. Guilford Press, New York, 1991(松島義博,後藤恵 訳:動機づけ面接法 基礎・実践編.星和書店,2007)
11) 守口善也,山口利昌,大場眞理子,他:摂食障害患者における外来診療の中断要因についての検討.心身医学 43:830-836, 2003
12) 西村宣子,竹田希美子,沖田肇,他:摂食障害患者の外来治療の継続について.精神科治療学 19:97-104,2004
13) Prochaska JO, DiClement CC:Transtheoretical therapy:Toward a more integrative model of change. Psychothrapy:Theory, Research and Practice 19:276-288, 1982
14) Prochaska JO, DiClemente CC, Norcross JC:In search of how people change. Applications to addictive behaviors. Am Psychol 47:1102-1114, 1992
15) Rosenberg M:Society and the Adolescent Self-image. Princeton University Press, Princeton, NJ, 1965
16) Steinhausen HC:The outcome of anorexia nervosa in the 20th century. Am J Psychiatry 159:1284-1293, 2002
17) Treasure JL, Katzman M, Schmidt U, et al:Engagement and outcome in the treatment of bulimia nervosa:First phase of a sequential design comparing motivation enhancement therapy and cognitive behavioural therapy. Behav Res Ther 37:405-418, 1999
18) Treasure J, Ward A:A practical guide to the use of motivational interviewing in anorexia nervosa. Eur Eat Disord Rev 5:102-114, 1997
19) Walsh BT, Fairburn CG, Mickley D, et al:Treatment of bulimia nervosa in a primary care setting. Am J Psychiatry 161:556-561, 2004
20) Walsh BT, Kaplan AS, Attia E, et al:Fluoxetine after weight restoration in anorexia nervosa:A randomized controlled trial. JAMA 295:2605-2612, 2006
21) Wolk SL, Devlin MJ:Stage of change as a predictor of response to psychotherapy for bulimia nervosa. Int J Eat Disord 30:96-100, 2001
22) Zeeck A, Hartmann A, Buchholz C, et al:Drop outs from in-patient treatment of anorexia nervosa. Acta Psychiatr Scand 111:29-37, 2005

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-126X

印刷版ISSN:0488-1281

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