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饮食失调症治疗的早期反应:系统评价与诊断试验准确性的Meta分析

Early Response to treatment in Eating Disorders: A Systematic Review and a Diagnostic Test Accuracy Meta-Analysis.

作者信息

Nazar Bruno Palazzo, Gregor Louise Kathrine, Albano Gaia, Marchica Angelo, Coco Gianluca Lo, Cardi Valentina, Treasure Janet

机构信息

Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK.

Federal University of Rio de Janeiro, Institute of Psychiatry (IPUB-UFRJ), Brazil.

出版信息

Eur Eat Disord Rev. 2017 Mar;25(2):67-79. doi: 10.1002/erv.2495. Epub 2016 Dec 7.

Abstract

OBJECTIVE

Early response to eating disorders treatment is thought to predict a later favourable outcome. A systematic review of the literature and meta-analyses examined the robustness of this concept.

METHOD

The criteria used across studies to define early response were summarised following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Diagnostic Test Accuracy methodology was used to estimate the size of the effect.

RESULTS

Findings from 24 studies were synthesized and data from 14 studies were included in the meta-analysis. In Anorexia Nervosa, the odds ratio of early response predicting remission was 4.85(95%CI: 2.94-8.01) and the summary Area Under the Curve (AUC) = .77. In Bulimia Nervosa, the odds ratio was 2.75(95%CI:1.24-6.09) and AUC = .67. For Binge Eating Disorder, the odds ratio was 5.01(95%CI: 3.38-7.42) and AUC = .71.

CONCLUSION

Early behaviour change accurately predicts later symptom remission for Anorexia Nervosa and Binge Eating Disorder but there is less predictive accuracy for Bulimia Nervosa. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

摘要

目的

饮食失调治疗的早期反应被认为可预测后期的良好预后。一项文献系统综述和荟萃分析检验了这一概念的可靠性。

方法

按照系统综述和荟萃分析的首选报告项目指南,总结了各研究中用于定义早期反应的标准。采用诊断试验准确性方法来估计效应大小。

结果

综合了24项研究的结果,14项研究的数据纳入了荟萃分析。在神经性厌食症中,早期反应预测缓解的优势比为4.85(95%置信区间:2.94 - 8.01),汇总曲线下面积(AUC)= 0.77。在神经性贪食症中,优势比为2.75(95%置信区间:1.24 - 6.09),AUC = 0.67。对于暴饮暴食症,优势比为5.01(95%置信区间:3.38 - 7.42),AUC = 0.71。

结论

早期行为改变能准确预测神经性厌食症和暴饮暴食症后期的症状缓解,但对神经性贪食症的预测准确性较低。版权所有© 2016约翰威立父子有限公司和饮食失调协会。

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