Walker D Catherine, Donahue Joseph M, Heiss Sydney, Gorrell Sasha, Anderson Lisa M, Brooks Julia M, Ehrlich Emily P, Morison Julie N, Anderson Drew A
Department of Psychology, Union College, 807 Union Street, Schenectady, NY, USA.
Department of Psychology, University at Albany, State University of New York, Albany, NY, USA.
Eat Weight Disord. 2021 Jun;26(5):1345-1356. doi: 10.1007/s40519-020-00939-y. Epub 2020 Jun 7.
There is a growing call to identify specific outcome predictors in real-world eating disorder (ED) treatment settings. Studies have implicated several ED treatment outcome predictors [rapid response (RR), weight suppression, illness duration, ED diagnosis, and psychiatric comorbidity] in inpatient settings or randomized controlled trials of individual outpatient therapy. However, research has not yet examined outcome predictors in intensive outpatient programs (IOP). The current study aimed to replicate findings from randomized controlled research trials and inpatient samples, identifying treatment outcome predictors in a transdiagnostic ED IOP sample.
The current sample comprised 210 consecutive unique IOP patient admissions who received evidence-based ED treatment, M(SD) = 15.82 (13.38) weeks. Weekly patient measures of ED symptoms and global functioning were obtained from patients' medical charts.
In relative weight analysis, RR was the only significant predictor of ED symptoms post treatment, uniquely accounting for 45.6% of the predicted variance in ED symptoms. In contrast, baseline ED pathology was the strongest unique predictor of end-of-treatment global functioning, accounting for 15.89% of predicted variance. Baseline factors did not differentiate patients who made RR from those who did not.
Consistent with findings in more controlled treatment settings, RR remains a robust predictor of outcome for patients receiving IOP-level treatment for EDs. Future work should evaluate factors that mediate and moderate RR, incorporating these findings into ED treatment design and implementation.
Level IV, uncontrolled intervention.
在现实世界的饮食失调（ED）治疗环境中，识别特定结果预测因素的呼声越来越高。研究表明，在住院环境或个体门诊治疗的随机对照试验中，有几个ED治疗结果预测因素[快速反应（RR）、体重抑制、病程、ED诊断和精神共病]。然而，研究尚未考察强化门诊项目（IOP）中的结果预测因素。本研究旨在重复随机对照研究试验和住院样本的结果，在一个跨诊断ED IOP样本中识别治疗结果预测因素。
当前样本包括210名连续接受循证ED治疗的独特IOP患者，平均治疗时间M（标准差）=15.82（13.38）周。从患者病历中获取患者每周的ED症状和整体功能测量数据。
在相对体重分析中，RR是治疗后ED症状的唯一显著预测因素，独特地占ED症状预测方差的45.6%。相比之下，基线ED病理学是治疗结束时整体功能最强的独特预测因素，占预测方差的15.89%。基线因素无法区分出现RR的患者和未出现RR的患者。
与在更严格控制的治疗环境中的发现一致，RR仍然是接受IOP级ED治疗患者结果的有力预测因素。未来的工作应评估介导和调节RR的因素，并将这些发现纳入ED治疗设计和实施中。
IV级，非对照干预。
