Adolescent Medicine Service, KK Women's and Children's Hospital, Singapore.
Department of Psychology, KK Women's and Children's Hospital, Singapore.
Int J Eat Disord. 2021 Jan;54(1):107-116. doi: 10.1002/eat.23429. Epub 2020 Dec 8.
This study describes the implementation of family-based treatment (FBT) in an eating disorder program in Asia as well as clinical outcomes of Asian adolescents with anorexia nervosa (AN) treated with FBT.
This retrospective consecutive cohort study of 147 Asian adolescents with AN was compared between those in FBT (n = 65) versus treatment as usual (TAU) (n = 82). Variables associated with weight restoration were analyzed between groups.
Participants' mean age was 14.2 (SD = 1.5) years and 93% were female. Mean presenting %mBMI was 74.0 (SD = 7.8) and average illness duration was 7.7 (SD = 6.1) months. The two groups' baseline characteristics were not significantly different. Weight restoration rates in the FBT group were significantly higher than the TAU group at 6-, 12-, and 24-month time points. A linear mixed model showed the mean %mBMI was significantly higher at 0, 6, 12, and 24 months in the FBT group. The median time to weight restoration for patients on FBT was shorter (FBT: 7.0 months, TAU: 19.0 months; 95% CI [14.5, 23.5] χ = 15.84, p < .001). Within the FBT group, those that completed ≥9 FBT sessions had significantly higher rates of weight restoration at 12 months. Across all participants, those with a lower starting %mBMI were less likely to achieve weight restoration by 12 months.
FBT can be effectively implemented in a multidisciplinary eating disorder program managing Asian adolescents with AN with improved rates of weight restoration. Further research is needed to understand the predictors and moderators of remission using FBT in Asian adolescents with AN.
本研究描述了在亚洲的一个饮食失调项目中实施家庭为基础的治疗(FBT)的情况,以及接受 FBT 治疗的亚洲青少年厌食症(AN)患者的临床结果。
这项回顾性连续队列研究纳入了 147 名亚洲青少年 AN 患者,比较了接受 FBT(n=65)与接受常规治疗(TAU)(n=82)的患者。分析了两组间与体重恢复相关的变量。
参与者的平均年龄为 14.2(SD=1.5)岁,93%为女性。平均初始 %mBMI 为 74.0(SD=7.8),平均病程为 7.7(SD=6.1)个月。两组的基线特征无显著差异。FBT 组在 6、12 和 24 个月时的体重恢复率显著高于 TAU 组。线性混合模型显示,FBT 组在 0、6、12 和 24 个月时的平均 %mBMI 显著更高。接受 FBT 的患者体重恢复的中位数时间更短(FBT:7.0 个月,TAU:19.0 个月;95%CI[14.5,23.5]χ=15.84,p<.001)。在 FBT 组中,完成≥9 次 FBT 治疗的患者在 12 个月时体重恢复率显著更高。在所有参与者中,起始 %mBMI 较低的患者在 12 个月时体重恢复的可能性较低。
FBT 可以在多学科饮食失调项目中有效实施,用于治疗亚洲青少年 AN,提高体重恢复率。需要进一步研究,以了解 FBT 治疗亚洲青少年 AN 患者的缓解预测因子和调节因素。