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在公共卫生保健环境中为青少年神经性厌食症提供基于家庭的治疗:研究性与非研究性专科护理。

Delivery of Family-Based Treatment for Adolescent Anorexia Nervosa in a Public Health Care Setting: Research Versus Non-Research Specialty Care.

作者信息

Le Grange Daniel, Gorrell Sasha, Hughes Elizabeth K, Accurso Erin C, Yeo Michele, Pradel Martin, Sawyer Susan M

机构信息

Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.

Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, Chicago, IL, United States.

出版信息

Front Psychiatry. 2020 Jan 22;10:1001. doi: 10.3389/fpsyt.2019.01001. eCollection 2019.

Abstract

UNLABELLED

Comparing evidence-based psychotherapy (EBP) to usual care typically demonstrates the superiority of EBPs, although this has not been studied for eating disorders EBPs such as family-based treatment (FBT). The current study set out to examine weight outcomes for adolescents with anorexia nervosa who received FBT through a randomized clinical research trial (RCT, = 54) or non-research specialty care ( = 56) at the same specialist pediatric eating disorder service. Weight was recorded throughout outpatient treatment (up to 18 sessions over 6 months), as well as at 6- and 12-month follow-up. Survival curves were used to examine time to weight restoration [greater than 95% median body mass index (mBMI)] as predicted by type of care (RCT vs. non-research specialty care), baseline clinical and demographic characteristics, and their potential interaction. Results did not indicate a significant main effect for type of care, but there was a significant effect for baseline weight ( = .03), such that weight restoration was achieved faster across both treatment types for those with a higher initial %mBMI. These data suggest that weight restoration achieved in non-research specialty care FBT was largely similar to that achieved in a controlled research trial.

CLINICAL TRIAL REGISTRATION

http://www.anzctr.org.au/, identifier ACTRN12610000216011.

摘要

未标注

将循证心理治疗(EBP)与常规治疗进行比较,通常可证明循证心理治疗的优越性,不过针对饮食失调的循证心理治疗,如基于家庭的治疗(FBT),尚未有相关研究。本研究旨在通过一项随机临床研究试验(RCT,n = 54)或在同一家专科儿科饮食失调服务机构接受非研究性专科护理(n = 56),来检验接受FBT的神经性厌食青少年的体重结果。在整个门诊治疗期间(6个月内最多18次疗程)以及6个月和12个月随访时记录体重。生存曲线用于检验体重恢复时间[大于95%的中位数体重指数(mBMI)],该时间由护理类型(RCT与非研究性专科护理)、基线临床和人口统计学特征及其潜在相互作用预测。结果未显示护理类型有显著的主效应,但基线体重有显著效应(P = 0.03),即对于初始mBMI百分比更高的患者,两种治疗类型的体重恢复都更快。这些数据表明,在非研究性专科护理FBT中实现的体重恢复与在对照研究试验中实现的体重恢复基本相似。

临床试验注册

http://www.anzctr.org.au/,标识符ACTRN12610000216011。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/459f/6987240/8e3edf3449f0/fpsyt-10-01001-g001.jpg

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