Sloane Madden, Department of Psychological Medicine, Sydney Children's Hospital Network, Westmead NSW 2145, Australia.
World J Psychiatry. 2015 Mar 22;5(1):147-53. doi: 10.5498/wjp.v5.i1.147.
To compare outcomes in anorexia nervosa (AN) in different treatment settings: inpatient, partial hospitalization and outpatient.
Completed and published in the English language, randomized controlled trials comparing treatment in two or more settings or comparing different lengths of inpatient stay, were identified by database searches using terms "anorexia nervosa" and "treatment" dated to July 2014. Trials were assessed for risk of bias and quality according to the Cochrane handbook by two authors (Madden S and Hay P) Data were extracted on trial quality, participant features and setting, main outcomes and attrition.
Five studies were identified, two comparing inpatient treatment to outpatient treatment, one study comparing different lengths of inpatient treatment, one comparing inpatient treatment to day patient treatment and one comparing day patient treatment with outpatient treatment. There was no difference in treatment outcomes between the different treatment settings and different lengths of inpatient treatment. Both outpatient treatment and day patient treatment were significantly cheaper than inpatient treatment. Brief inpatient treatment followed by evidence based outpatient care was also cheaper than prolonged inpatient care for weight normalization also followed by evidence based outpatient care.
There is preliminary support for AN treatment in less restrictive settings but more research is needed to identify the optimum treatment setting for anorexia nervosa.
比较不同治疗环境下（住院、部分住院和门诊）神经性厌食症（AN）的治疗结果。
通过数据库搜索，使用“神经性厌食症”和“治疗”的术语，检索截至 2014 年 7 月的已完成并发表的英文随机对照试验，比较两种或多种治疗环境的治疗或比较不同住院时间的长短。两位作者（Madden S 和 Hay P）根据 Cochrane 手册评估试验的偏倚风险和质量。提取关于试验质量、参与者特征和环境、主要结局和流失的信息。
确定了 5 项研究，其中 2 项比较了住院治疗与门诊治疗，1 项研究比较了不同住院时间长短的治疗，1 项比较了住院治疗与日间治疗，1 项比较了日间治疗与门诊治疗。不同治疗环境和不同住院时间的治疗结果无差异。门诊治疗和日间治疗均显著低于住院治疗，对于体重正常化，随后采用基于证据的门诊治疗，短时间住院治疗后进行基于证据的门诊治疗也比长时间住院治疗更为便宜。
有初步证据支持在限制较少的环境中治疗 AN，但需要更多的研究来确定 AN 的最佳治疗环境。
