Le Grange Daniel, Lock James, Accurso Erin C, Agras W Stewart, Darcy Alison, Forsberg Sarah, Bryson Susan W
University of Chicago.
Stanford University, Stanford, CA.
J Am Acad Child Adolesc Psychiatry. 2014 Nov;53(11):1162-7. doi: 10.1016/j.jaac.2014.07.014. Epub 2014 Aug 23.
Long-term follow-up studies documenting maintenance of treatment effects are few in adolescent anorexia nervosa (AN). This exploratory study reports relapse from full remission and attainment of remission during a 4-year open follow-up period using a convenience sample of a subgroup of 65% (n = 79) from an original cohort of 121 participants who completed a randomized clinical trial comparing family-based therapy (FBT) and adolescent-focused individual therapy (AFT).
Follow-up assessments were completed up to 4 years posttreatment (average, 3.26 years). Available participants completed the Eating Disorder Examination as well as self-report measures of self-esteem and depression at 2 to 4 years posttreatment.
Two participants (6.1%) relapsed (FBT: n = 1, 4.5%; AFT: n = 1, 9.1%), on average 1.98 years (SD = 0.14 years) after remission was achieved at 1-year follow-up. Ten new participants (22.7%) achieved remission (FBT: n = 1, 5.9%; AFT: n = 9, 33.3%). Mean time to remission for this group was 2.01 years (SD = 0.82 years) from 1-year follow-up. There were no differences based on treatment group assignment in either relapse from full remission or new remission during long-term follow-up. Other psychopathology was stable over time.
There were few changes in the clinical presentation of participants who were assessed at long-term follow-up. These data suggest that outcomes are generally stable posttreatment regardless of treatment type once remission is achieved. Clinical trial registration information-Effectiveness of Family-Based Versus Individual Psychotherapy in Treating Adolescents With Anorexia Nervosa; http://www.clinicaltrials.gov/; NCT00149786.
记录青少年神经性厌食症（AN）治疗效果维持情况的长期随访研究较少。本探索性研究报告了在一项为期4年的开放随访期内，从121名完成了一项比较家庭治疗（FBT）和青少年个体治疗（AFT）的随机临床试验的原始队列中选取的65%（n = 79）亚组的便利样本中，从完全缓解状态复发以及达到缓解的情况。
随访评估在治疗后长达4年（平均3.26年）时完成。参与的受试者在治疗后2至4年完成了饮食失调检查以及自尊和抑郁的自我报告测量。
两名受试者（6.1%）复发（FBT组：n = 1，4.5%；AFT组：n = 1，9.1%），平均在1年随访达到缓解后1.98年（标准差 = 0.14年）复发。十名新受试者（22.7%）达到缓解（FBT组：n = 1，5.9%；AFT组：n = 9，33.3%）。该组从1年随访开始达到缓解的平均时间为2.01年（标准差 = 0.82年）。在长期随访期间，无论是从完全缓解状态复发还是新达到缓解，基于治疗组分配均无差异。其他精神病理学情况随时间保持稳定。
在长期随访中接受评估的受试者临床表现变化较少。这些数据表明，一旦实现缓解，无论治疗类型如何，治疗后的结果总体上是稳定的。临床试验注册信息——家庭治疗与个体心理治疗对青少年神经性厌食症的疗效；http://www.clinicaltrials.gov/；NCT00149786。
