Anorexia nervosa – eine metabolisch-psychiatrische Erkrankung?

ZUSAMMENFASSUNG

Die Anorexia nervosa (AN) ist die psychische Erkrankung mit der höchsten Mortalität. Individuen, die im Jugendalter erkranken, leiden durchschnittlich über 10 Jahre an dieser Störung. Obwohl die klinische Erfahrung und internationale sowie nationale Studien auf einen unzureichenden Heilungserfolg hinweisen, wird in Deutschland meist an der traditionellen langdauernden stationären Behandlung festgehalten. Studien zur Erforschung der Ätiologie haben neue Erkenntnisse gebracht. Der vorliegende Artikel will beispielhaft neue biologische und psychologische Interventionen aufzeigen, die die Prognose dieser Erkrankung verbessern könnten. Dazu gehören therapeutische Strategien, die auf das Darm-Mikrobiom und damit auf die Darm-Gehirn-Achse Einfluss nehmen, eine neue experimentelle Behandlung mit Metreleptin (rekombinantes menschliches Leptin) sowie ein neues Behandlungssetting, das Home-Treatment. Nach erfolgreichen Pilotstudien soll in randomisiert-kontrollierten Studien herausgefunden werden, wie eine „personalisierte Behandlung“ der AN in Abhängigkeit von Schweregrad und Krankheitsdauer durchgeführt werden könnte.

ABSTRACT

Anorexia nervosa has the highest mortality of all psychiatric disorders. Young people with an onset of the disease in adolescence suffer on average for more than ten years from an eating disorder. Advancing knowledge of the aetiology of this disorder could inform biological and psychological interventions which might improve the prognosis of this long-lasting illness. This article will present three examples of new therapeutic strategies which 1) target the gut microbiome and the gut-brain axis, 2) explore the effects of a new pharmacological agent, the experimental application of metreleptin (recombinant human leptin) and 3) investigate a new treatment setting which involves the patient, her caregivers and her home environment (home treatment). After pilot studies with satisfactory results, it is the aim of current ongoing randomized controlled trials to find out for which patients at what stage of the illness these treatments might improve the outcome of this disabling disorder.

Schlüsselwörter

Anorexia nervosa - Adoleszenz - Behandlung - Darmmikrobiom - Metreleptin - Home-Treatment

Key words

Anorexia nervosa - adolescence - treatment - gut microbiome - metreleptin - home treatment

Publikationsverlauf

Artikel online veröffentlicht:
05. Mai 2022

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