Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of General Psychology, University of Padova, Padova, Italy.
Eur Eat Disord Rev. 2021 May;29(3):355-370. doi: 10.1002/erv.2824. Epub 2021 Mar 9.
In the short term, intensive treatment focusing on restoring weight for anorexia nervosa can remediate many symptoms. However, there is a high level of relapse after discharge. This paper examines interventions developed to bridge the transition from intensive to less intensive forms of treatment for adult anorexia nervosa.
We undertook a systematic review of the literature on interventions aimed at providing transition support. The Template for Intervention Description and Replication was used to describe components of the transition interventions. Patient's drop-out rates, weight, eating disorder psychopathology and mood data were extracted at end of treatment and follow-up to describe preliminary efficacy.
Fourteen studies were selected: nine used psychological interventions delivered through face-to-face talking therapy or guided self-help, three examined the use of fluoxetine and two assessed stepped-care approaches. Transition support was delivered to patients in 11 studies, to patients and carers in two studies, and carers alone in another study.
There was a great heterogeneity in the content and structure of the transition interventions evaluated. Overall, drop-out rates were lower for psychological support than pharmacological interventions or stepped-care approaches. Changes in eating disorder outcomes and mood were small to moderate throughout for studies that included a comparison group.
短期内，以恢复体重为重点的强化治疗可以改善厌食症的许多症状。然而，出院后复发率很高。本文研究了为缓解成人厌食症从强化治疗向非强化治疗过渡而开发的干预措施。
我们对旨在提供过渡支持的干预措施的文献进行了系统回顾。使用干预描述和复制模板来描述过渡干预的组成部分。在治疗结束和随访时提取患者的脱落率、体重、饮食障碍心理病理学和情绪数据，以描述初步疗效。
共选择了 14 项研究：9 项研究使用通过面对面谈话治疗或指导自助提供的心理干预，3 项研究评估了氟西汀的使用，2 项研究评估了分级护理方法。11 项研究向患者提供过渡支持，2 项研究向患者和照顾者提供过渡支持，另 1 项研究仅向照顾者提供过渡支持。
评估的过渡干预在内容和结构上存在很大的异质性。总体而言，与药物干预或分级护理方法相比，心理支持的脱落率较低。纳入对照组的研究中，饮食障碍结局和情绪的变化较小到中等。
