Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
Department of Pediatrics, University of Michigan, Ann Arbor, Michigan.
Int J Eat Disord. 2020 Apr;53(4):606-610. doi: 10.1002/eat.23248. Epub 2020 Feb 24.
Improved treatment outcome in family-based treatment (FBT) for anorexia nervosa (AN) is predicted by weight gain occurring early in the course of treatment (i.e., about 4 lbs by week 4). Although prior work suggests that early weight gain in higher levels of care (e.g., partial hospitalization programs [PHP]) predicts weight restoration at discharge, no study has examined the specific rate of gain within FBT-informed PHP programs that best predicts treatment response.
This study examined rate of weight gain in pounds and percent expected body weight (EBW) that predicts positive outcome in 70 patients (M age = 15.49 years, SD = 2.56) with AN who were enrolled in a family-based PHP.
Receiver operator characteristic analyses demonstrated that changes in %EBW during weeks 2-5 were more useful than changes in weight in predicting positive outcome. Gaining at least 8.9 pounds or over 8% of EBW in the first 4 weeks of treatment significantly predicted positive outcome.
Findings suggest that positive outcome in an FBT-informed PHP is predicted by rapid weight gain in the initial weeks of treatment. Research is needed to identify specific family and patient characteristics that facilitate weight gain and to develop corresponding interventions to improve outcome.
家庭为基础的治疗(FBT)治疗神经性厌食症(AN)的疗效改善与治疗早期(即第 4 周时增重约 4 磅)的体重增加有关。尽管先前的研究表明,较高水平护理(如部分住院计划[PHP])中的早期体重增加预测出院时的体重恢复,但尚无研究检查在基于 FBT 的 PHP 计划中,最佳预测治疗反应的特定体重增加率。
本研究在 70 名接受家庭为基础的 PHP 治疗的 AN 患者(M 年龄=15.49 岁,SD=2.56)中,检查了体重增加的磅数和预期体重的百分比(EBW),以预测治疗效果。
接收者操作特征分析表明,第 2-5 周期间 EBW 的变化比体重变化更能预测积极的结果。在治疗的前 4 周内增重至少 8.9 磅或 EBW 的 8%以上,显著预测了积极的结果。
研究结果表明,FBT 知情的 PHP 中的积极结果是由治疗早期的快速体重增加预测的。需要研究来确定促进体重增加的特定家庭和患者特征,并开发相应的干预措施以改善结果。