Herscovici Cecile Rausch, Kovalskys Irina, Orellana Liliana
Committee on Nutrition, Health and Quality of Life, International Life Sciences Institute (ILSI Argentina), Buenos Aires, Argentina.
Faculty of Health, Deakin University, Burwood, Vic., Australia.
Fam Process. 2017 Jun;56(2):364-375. doi: 10.1111/famp.12199. Epub 2015 Nov 24.
Although weight restoration is a crucial factor in the recovery of anorexia nervosa (AN), there is scarce evidence regarding which components of treatment promote it. In this paper, the author reports on an effort to utilize research methods in her own practice, with the goal of evaluating if the family meal intervention (FMI) had a positive effect on increasing weight gain or on improving other general outcome measures. Twenty-three AN adolescents aged 12-20 years were randomly assigned to two forms of outpatient family therapy (with [FTFM] and without [FT]) using the FMI, and treated for a 6-month duration. Their outcome was compared at the end of treatment (EOT) and at a 6-month posttreatment follow-up (FU). The main outcome measure was weight recovery; secondary outcome measures were the Morgan Russell Global Assessment Schedule (MRHAS), amenorrhea, general psychological symptoms, and eating disorder symptoms. The majority of the patients in both groups improved significantly at EOT, and these changes were sustained through FU. Given its primarily clinical nature, findings of this investigation project preclude any conclusion. Although the FMI did not appear to convey specific benefits in causing weight gain, clinical observation suggests the value of a flexible stance in implementation of the FMI for the severely undernourished patient with greater psychopathology.
尽管体重恢复是神经性厌食症(AN)康复的关键因素,但关于治疗的哪些组成部分能促进体重恢复的证据却很少。在本文中,作者报告了在自己的实践中运用研究方法的一项努力,目的是评估家庭聚餐干预(FMI)对增加体重或改善其他一般结果指标是否有积极影响。23名年龄在12至20岁的AN青少年被随机分配到使用FMI的两种门诊家庭治疗形式(有[FTFM]和无[FT]),并接受为期6个月的治疗。在治疗结束时(EOT)和治疗后6个月的随访(FU)时对他们的结果进行了比较。主要结果指标是体重恢复;次要结果指标是摩根·拉塞尔整体评估量表(MRHAS)、闭经、一般心理症状和饮食失调症状。两组中的大多数患者在EOT时都有显著改善,并且这些变化在FU期间得以维持。鉴于该调查项目主要具有临床性质,其结果无法得出任何结论。尽管FMI在导致体重增加方面似乎没有带来特定益处,但临床观察表明,对于患有更严重精神病理学的严重营养不良患者,在实施FMI时采取灵活立场具有价值。