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青少年神经性厌食症短期与长期家庭治疗的比较

A comparison of short- and long-term family therapy for adolescent anorexia nervosa.

作者信息

Lock James, Agras W Stewart, Bryson Susan, Kraemer Helena C

机构信息

Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 2005 Jul;44(7):632-9. doi: 10.1097/01.chi.0000161647.82775.0a.

Abstract

OBJECTIVE

Research suggests that family treatment for adolescents with anorexia nervosa may be effective. This study was designed to determine the optimal length of such family therapy.

METHOD

Eighty-six adolescents (12-18 years of age) diagnosed with anorexia nervosa were allocated at random to either a short-term (10 sessions over 6 months) or long-term treatment (20 sessions over 12 months) and evaluated at the end of 1 year using the Eating Disorder Examination (EDE) between 1999 and 2002.

RESULTS

Although adequately powered to detect differences between treatment groups, an intent-to-treat analysis found no significant differences between the short-term and long-term treatment groups. Although a nonsignificant finding does not prove the null hypothesis, in no instance does the confidence interval on the effect size on the difference between the groups approach a moderate .5 level. However, post hoc analyses suggest that subjects with severe eating-related obsessive-compulsive features or who come from nonintact families respond better to long-term treatment.

CONCLUSIONS

A short-term course of family therapy appears to be as effective as a long-term course for adolescents with short-duration anorexia nervosa. However, there is a suggestion that those with more severe eating-related obsessive-compulsive thinking and nonintact families benefit from longer treatment.

摘要

目的

研究表明,针对神经性厌食症青少年的家庭治疗可能有效。本研究旨在确定这种家庭治疗的最佳疗程。

方法

86名诊断为神经性厌食症的青少年(12 - 18岁)被随机分配到短期治疗组(6个月内进行10次治疗)或长期治疗组(12个月内进行20次治疗),并于1999年至2002年期间在1年结束时使用饮食失调检查(EDE)进行评估。

结果

尽管有足够的能力检测治疗组之间的差异,但意向性分析发现短期和长期治疗组之间没有显著差异。虽然非显著结果不能证明零假设,但在任何情况下,两组之间效应大小的置信区间都未接近中等的0.5水平。然而,事后分析表明,具有严重饮食相关强迫特征或来自不完整家庭的受试者对长期治疗反应更好。

结论

对于病程较短的神经性厌食症青少年,短期家庭治疗疗程似乎与长期疗程一样有效。然而,有迹象表明,那些有更严重饮食相关强迫思维和不完整家庭的青少年从更长疗程的治疗中获益。

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