Department of Psychiatry, University of California, San Francisco, CA.
The University of Melbourne, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.
Eur Eat Disord Rev. 2020 May;28(3):351-357. doi: 10.1002/erv.2725. Epub 2020 Jan 29.
Rates of psychiatric comorbidity are elevated in adolescents with anorexia nervosa, but little is known about how psychiatric comorbidity changes following family-based treatment (FBT).
Adolescents with anorexia nervosa (N = 107) enrolled in a randomized controlled trial comparing two forms of FBT completed the Mini International Neuropsychiatric Interview for Children and Adolescents at baseline and end of treatment. Analyses tested whether baseline comorbid diagnoses predicted the presence of comorbid diagnoses at end of treatment and if baseline eating disorder psychopathology impacted this association.
Rates of comorbid diagnoses decreased from 54% at baseline to 26% at end of treatment. Logistic regression analyses indicated that individuals with multiple comorbid diagnoses at baseline were more likely to meet criteria for a comorbid condition at end of treatment (b = 2.00, p < .05). Individuals with reported psychotropic medication use were less likely to meet criteria for a comorbid condition at end of treatment (b = -1.63, p = .04). Diagnostic rates for major depressive disorder, generalized anxiety disorder, and panic disorder/agoraphobia decreased following FBT.
Findings suggest that FBT for adolescent anorexia nervosa may aid in the resolution of some co-occurring psychiatric diagnoses. Continued research is needed to understand factors contributing to comorbid symptom improvement throughout treatment.
厌食症青少年的精神共病率较高，但对于基于家庭的治疗（FBT）后精神共病如何变化知之甚少。
参加比较两种形式的 FBT 的随机对照试验的厌食症青少年（N=107）在基线和治疗结束时完成儿童和青少年迷你国际神经精神访谈。分析测试了基线共病诊断是否预测治疗结束时共病诊断的存在，以及基线饮食障碍心理病理学是否影响这种关联。
共病诊断率从基线时的 54%下降到治疗结束时的 26%。逻辑回归分析表明，基线时存在多种共病诊断的个体更有可能在治疗结束时符合共病条件的标准（b=2.00，p<.05）。报告使用精神药物的个体在治疗结束时更不可能符合共病条件的标准（b=-1.63，p=.04）。FBT 后，重度抑郁症、广泛性焦虑症和惊恐障碍/广场恐怖症的诊断率下降。
研究结果表明，FBT 治疗青少年厌食症可能有助于解决一些共患的精神诊断。需要进一步研究以了解治疗过程中导致共病症状改善的因素。
