Lindstedt Katarina, Forss Emma, Elwin Marie, Kjellin Lars, Gustafsson Sanna Aila
1University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
2Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Child Adolesc Psychiatry Ment Health. 2020 May 2;14:16. doi: 10.1186/s13034-020-00323-9. eCollection 2020.
Despite major research efforts, current recommendations of treatment interventions for adolescents with anorexia nervosa are scarce, and the importance of patient satisfaction for treatment outcome is yet to be established. The overall aim of the present study was to examine treatment interventions and patient satisfaction in a naturalistic sample of adolescents with anorexia nervosa or subthreshold anorexia nervosa and possible associations to outcome defined as being in remission or not at treatment follow-up.
Participants were identified through the Swedish national quality register for eating disorder treatment (SwEat). The samples consisted of 1899 patients who were follow-up registered 1 year after entering treatment and 474 patients who had completed a 1-year patient satisfaction questionnaire. A two-step cluster analysis was used for identifying subgroups of patients who received certain combinations and various amounts of treatment forms.
Patients who received mainly family-based treatment and/or inpatient care were most likely to achieve remission at 1-year follow-up, compared to patients in the other clusters. They were also younger, in general. Individual therapy was the most common treatment form, and was most appreciated among the adolescents. At 1-year follow-up, many patients reported improvements in eating habits, but far fewer reported improvements regarding cognitive symptoms. Overall, the patients rated the therapist relationship in a rather positive way, but they gave quite low ratings to statements associated with their own participation in treatment.
The results indicate that young adolescents who receive mainly family-based treatment and/or inpatient care respond more rapidly to treatment compared to older adolescents who receive mainly individual therapy or mixed treatment interventions. At 1-year follow-up, the adolescents reported improvements in behavioral symptoms and seemed quite satisfied with the therapist relationship.
尽管进行了大量研究，但目前针对神经性厌食症青少年的治疗干预建议仍然稀缺，患者满意度对治疗结果的重要性尚未确立。本研究的总体目标是在一个自然样本中，研究神经性厌食症或亚阈值神经性厌食症青少年的治疗干预措施和患者满意度，以及与治疗随访时是否缓解这一结果的可能关联。
通过瑞典国家饮食失调治疗质量登记册（SwEat）确定参与者。样本包括1899名进入治疗1年后进行随访登记的患者，以及474名完成了为期1年患者满意度问卷的患者。采用两步聚类分析来确定接受特定组合和不同数量治疗形式的患者亚组。
与其他组的患者相比，主要接受基于家庭的治疗和/或住院治疗的患者在1年随访时最有可能实现缓解。总体而言，他们也更年轻。个体治疗是最常见的治疗形式，并且在青少年中最受认可。在1年随访时，许多患者报告饮食习惯有所改善，但报告认知症状有所改善的患者要少得多。总体而言，患者对治疗师关系的评价较为积极，但对与自身参与治疗相关的陈述评价较低。
结果表明，与主要接受个体治疗或混合治疗干预的年长青少年相比，主要接受基于家庭的治疗和/或住院治疗的年轻青少年对治疗的反应更快。在1年随访时，青少年报告行为症状有所改善，并且似乎对治疗师关系相当满意。
