Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Eur Eat Disord Rev. 2019 May;27(3):283-294. doi: 10.1002/erv.2668. Epub 2019 Feb 13.
Early response, as indicated by early weight gain, in family-based treatment (FBT) for adolescent anorexia nervosa (AN) predicts remission at end of treatment. However, little is known about what factors contribute to early response. Further, no previous studies have examined early response to separated forms of FBT.
Data from a randomised clinical trial of conjoint FBT and separated FBT (parent-focused treatment, PFT) were analysed to examine the timing and amount of early weight gain that predicted remission and identify factors associated with early response.
Weight gain of at least 2.80 kg in FBT (N = 55) and 2.28 kg in PFT (N = 51), by Session 5, were the best predictors of remission at end of treatment. Early response in FBT was predicted by greater paternal therapeutic alliance and lower paternal criticism. Early response in PFT was predicted by less severe eating-disorder symptoms and negative affect at baseline, lower maternal criticism, and greater adolescent therapeutic alliance.
The results confirm that early weight gain is an important prognostic indicator in both conjoint FBT and PFT and suggest that addressing negative emotion, parental criticism, and therapeutic alliance early in treatment could improve remission rates.
家庭为基础的治疗（FBT）治疗青少年厌食症（AN）的早期体重增加表明治疗结束时的缓解。然而，对于哪些因素导致早期反应知之甚少。此外，以前没有研究检查过 FBT 的分离形式的早期反应。
分析了一项联合 FBT 和分离 FBT（以父母为焦点的治疗，PFT）的随机临床试验的数据，以检查预测缓解的早期体重增加的时间和数量，并确定与早期反应相关的因素。
在第 5 次治疗中，FBT（N=55）和 PFT（N=51）中体重增加至少 2.80kg 是治疗结束时缓解的最佳预测指标。FBT 的早期反应由更大的父亲治疗联盟和更低的父亲批评预测。PFT 的早期反应由基线时更严重的饮食障碍症状和负性情绪、更低的母亲批评和更大的青少年治疗联盟预测。
研究结果证实，在联合 FBT 和 PFT 中，早期体重增加是一个重要的预后指标，并表明在治疗早期解决负性情绪、父母批评和治疗联盟可以提高缓解率。
