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青少年神经性厌食症的住院治疗:一项为期 1 年的随访研究。

Inpatient treatment of anorexia nervosa in adolescents: A 1-year follow-up study.

机构信息

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.

Schoen Clinic Roseneck, Prien am Chiemsee, Germany.

出版信息

Eur Eat Disord Rev. 2021 Mar;29(2):165-177. doi: 10.1002/erv.2808. Epub 2020 Nov 24.

Abstract

OBJECTIVE

Inpatient treatment effectively increases body weight and decreases eating disorder symptoms in adolescents with anorexia nervosa (AN). However, there is a high risk of relapse within the first year after discharge, which calls for investigating long-term treatment success and its moderators.

METHOD

Female adolescent inpatients with AN (N = 142) were assessed, of which 85% participated at 1-year follow-up. Dependent variables were body mass index percentiles, eating disorder symptoms, depressive symptoms, compulsive exercise and life satisfaction.

RESULTS

On average, body weight increased and eating disorder symptoms and depressive symptoms decreased from admission to discharge and remained stable at follow-up. Compulsive exercise decreased and life satisfaction increased from admission to discharge and even improved further at follow-up. Age, duration of illness, previous inpatient treatments, length of stay and readmission after discharge moderated changes in several outcome variables.

CONCLUSIONS

This study confirms the high effectiveness of inpatient treatment for adolescents with AN and demonstrates that treatment effects remain stable or even improve further within the first year after discharge. However, subgroups of patients (e.g., those with an older age, longer duration of illness, and previous inpatient treatments) require special attention during inpatient treatment and aftercare to prevent relapse.

摘要

目的

住院治疗可有效增加青少年厌食症(AN)患者的体重并减轻其饮食障碍症状。然而,出院后第一年的复发风险很高,因此需要调查长期治疗的效果及其影响因素。

方法

对患有 AN 的女性青少年住院患者(N=142)进行评估,其中 85%的患者参加了 1 年随访。因变量为体重指数百分位数、饮食障碍症状、抑郁症状、强迫性运动和生活满意度。

结果

平均而言,体重从入院到出院时增加,饮食障碍症状和抑郁症状从入院到出院时减轻,且在随访时保持稳定。强迫性运动从入院到出院时减少,生活满意度从入院到出院时增加,甚至在随访时进一步提高。年龄、病程、既往住院治疗、住院时间和出院后再入院会影响几个结果变量的变化。

结论

本研究证实了住院治疗对青少年 AN 的高度有效性,并表明治疗效果在出院后第一年仍然稳定或甚至进一步改善。然而,某些亚组患者(例如年龄较大、病程较长和既往住院治疗的患者)在住院治疗和康复期间需要特别关注,以防止复发。

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