Wallis Andrew, Miskovic-Wheatley Jane, Madden Sloane, Alford Colleen, Rhodes Paul, Touyz Stephen
1 Eating Disorder Service, The Sydney Children's Hospital Network, Australia.
2 School of Psychology, The University of Sydney, Australia.
Clin Child Psychol Psychiatry. 2018 Oct;23(4):592-600. doi: 10.1177/1359104518775145. Epub 2018 May 20.
Our aim was to investigate the benefit of ongoing family-based treatment (FBT) sessions for adolescent anorexia nervosa if remission criteria were not met at session 20.
Participants were 69 medically unstable adolescents with Diagnostic and Statistical Manual of Mental Disorders (4th ed; DSM-IV) anorexia nervosa from a randomized controlled trial investigating length of hospital admission prior to outpatient FBT. Participants were divided post hoc into those meeting remission criteria at session 20 ( n = 16), those that had not remitted but continued with FBT ( n = 39) and those who ceased FBT undertaking alternative treatments ( n = 14). Outcome was assessed as remission and hospital readmission days at 12 months after FBT session 20.
There were no differences between groups at baseline. There was a significant difference in the use of hospital admission days with those in the Alternate Treatment Group who did not continue with FBT using 71.93 days compared to those in Additional FBT Group with only 12.51 days ( F(2, 66) = 13.239, p < .01). At 12 months after FBT session 20, the Additional FBT Group had a 28.2% increase in remission rate, significantly higher than those in the Alternate Treatment Group (χ(2) = 17.68, p < .001).
Continuing FBT after session 20 if remission is not achieved can significantly reduce hospital readmission days and improve remission rates.
我们的目的是研究如果在第20次治疗时未达到缓解标准，持续进行基于家庭的治疗（FBT）对青少年神经性厌食症的益处。
参与者为69名患有精神疾病诊断与统计手册（第4版；DSM-IV）神经性厌食症的医学上不稳定的青少年，他们来自一项调查门诊FBT之前住院时间的随机对照试验。参与者在事后被分为在第20次治疗时达到缓解标准的（n = 16）、未缓解但继续接受FBT的（n = 39）以及停止FBT并接受替代治疗的（n = 14）。结局评估为FBT第20次治疗后12个月的缓解情况和再次住院天数。
各组在基线时无差异。在住院天数的使用上存在显著差异，未继续接受FBT的替代治疗组使用了71.93天，而仅接受额外FBT组的住院天数为12.51天（F(2, 66) = 13.239，p <.01）。在FBT第20次治疗后12个月，额外FBT组的缓解率提高了28.2%，显著高于替代治疗组（χ(2) = 17.68，p <.001）。
如果在第20次治疗后未实现缓解，继续进行FBT可显著减少再次住院天数并提高缓解率。
