Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
Eating Disorders Outpatient Service, South London and Maudsley NHS Foundation Trust, London, UK.
Eur Eat Disord Rev. 2021 May;29(3):458-471. doi: 10.1002/erv.2797. Epub 2020 Oct 28.
Duration of untreated eating disorder (DUED), that is, the time between illness onset and start of first evidence-based treatment, is a key outcome for early intervention. Internationally, reported DUED ranges from 2.5 to 6 years for different eating disorders (EDs). To shorten DUED, we developed FREED (First Episode Rapid Early Intervention for EDs), a service model and care pathway for emerging adults with EDs. Here, we assess the impact of FREED on DUED in a multi-centre study using a quasi-experimental design.
Two hundred and seventy-eight patients aged 16-25, with first episode illness of less than 3 years duration, were recruited from specialist ED services and offered treatment via FREED. These were compared to 224 patients, of similar age and illness duration, seen previously in participating services (treatment as usual [TAU]) on DUED, waiting times and treatment uptake.
FREED patients had significantly shorter DUED and waiting times than TAU patients. On average, DUED was reduced by ∼4 months when systemic delays were minimal. Furthermore, 97.8% of FREED patients took up treatment, versus 75.4% of TAU.
Findings indicate that FREED significantly improves access to treatment for emerging adults with first episode ED. FREED may reduce distress, prevent deterioration and facilitate recovery.
未治疗进食障碍期（DUED），即从疾病发作到首次进行基于证据的治疗的时间，是早期干预的关键结果。在国际上，不同的进食障碍（ED）报告的 DUED 从 2.5 年到 6 年不等。为了缩短 DUED，我们开发了 FREED（ED 的首次发作快速早期干预），这是一种针对新兴成年人 ED 的服务模式和护理途径。在这里，我们使用准实验设计评估 FREED 对多中心研究中 DUED 的影响。
招募了 278 名年龄在 16-25 岁之间、首发疾病持续时间不到 3 年的患者，他们来自专门的 ED 服务机构，并通过 FREED 提供治疗。将这些患者与 224 名年龄和疾病持续时间相似的患者进行比较，这些患者之前在参与服务机构（常规治疗[TAU]）中接受了 DUED、等待时间和治疗接受情况的评估。
FREED 患者的 DUED 和等待时间明显短于 TAU 患者。平均而言，当系统延迟最小化时，DUED 缩短了约 4 个月。此外，97.8%的 FREED 患者接受了治疗，而 TAU 患者为 75.4%。
研究结果表明，FREED 显著改善了新兴成年人首次发作 ED 的治疗机会。FREED 可能减轻痛苦、防止恶化并促进康复。
