Section of Eating Disorders, Institute of Psychiatry, King's College London, London, United Kingdom.
Int J Eat Disord. 2012 Jul;45(5):635-47. doi: 10.1002/eat.20956. Epub 2011 Aug 30.
Dropout from treatment has serious implications for patients, clinicians, and researchers. The aim of this study was to examine rates of dropout from outpatient treatment for anorexia nervosa (AN) and critically examine the various definitions of dropout used.
A systematic review was conducted, including pharmacological and psychological interventions. All articles in PubMed, Web of Science, and the Cochrane Library were considered, and screened against a priori inclusion/exclusion criteria. Relationships between treatment outcome and dropout rate were examined across studies.
Nineteen relevant studies were identified, with dropout rates ranging from 4.8% (family therapy) to 100% (dietary advice). In most cases, dropout was in the range of 20-40%. Definitions of dropout used varied widely. A significant negative correlation was found between rate of dropout and body mass index (BMI) at 1 year, but this did not remain significant when differences in BMI at baseline were taken into account.
High rates of dropout from treatment for AN have serious implications for recovery, research, and the development of new treatments. A suggested reporting structure is proposed, with the aim of increasing the consistency of dropout reporting and facilitating greater understanding of this phenomenon.
治疗中断对患者、临床医生和研究人员都有严重影响。本研究旨在检查神经性厌食症（AN）门诊治疗的中断率，并严格审查使用的各种中断定义。
进行了系统评价，包括药理学和心理干预。考虑了 PubMed、Web of Science 和 Cochrane Library 中的所有文章，并根据事先制定的纳入/排除标准进行了筛选。研究之间检查了治疗结果与辍学率之间的关系。
确定了 19 项相关研究，辍学率从 4.8%（家庭治疗）到 100%（饮食建议）不等。在大多数情况下，辍学率在 20-40%之间。使用的辍学定义差异很大。在考虑基线 BMI 差异时，发现辍学率与 1 年后 BMI 之间存在显著负相关，但这一相关性在 1 年后不再显著。
AN 治疗中断率高对康复、研究和新治疗方法的发展都有严重影响。提出了一种建议的报告结构，旨在提高辍学报告的一致性，并促进对这一现象的更深入理解。
