Rienecke Renee D
Department of Pediatrics.
Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC.
Adolesc Health Med Ther. 2017 Jun 1;8:69-79. doi: 10.2147/AHMT.S115775. eCollection 2017.
Eating disorders are serious illnesses associated with significant morbidity and mortality. Family-based treatment (FBT) has emerged as an effective intervention for adolescents with anorexia nervosa, and preliminary evidence suggests that it may be efficacious in the treatment of adolescents with bulimia nervosa. Multifamily therapy for anorexia nervosa provides a more intensive experience for families needing additional support. This review outlines the three phases of treatment, key tenets of family-based treatment, and empirical support for FBT. In addition, FBT in higher levels of care is described, as well as challenges in the implementation of FBT and recent adaptations to FBT, including offering additional support to eating-disorder caregivers. Future research is needed to identify families for whom FBT does not work, determine adaptations to FBT that may increase its efficacy, develop ways to improve treatment adherence among clinicians, and find ways to support caregivers better during treatment.
饮食失调是与高发病率和死亡率相关的严重疾病。基于家庭的治疗(FBT)已成为治疗神经性厌食症青少年的有效干预措施,初步证据表明,它可能对治疗神经性贪食症青少年有效。针对神经性厌食症的多家庭治疗为需要额外支持的家庭提供了更深入的体验。本综述概述了治疗的三个阶段、基于家庭治疗的关键原则以及FBT的实证支持。此外,还描述了更高护理水平下的FBT,以及FBT实施中的挑战和FBT的最新调整,包括为饮食失调患者的照顾者提供额外支持。未来需要开展研究,以确定哪些家庭不适合FBT,确定可能提高其疗效的FBT调整方法,开发提高临床医生治疗依从性的方法,并找到在治疗期间更好地支持照顾者的方法。