Blackbird Initiative, Órama Research Institute, Flinders University, South Australia, Australia.
Department of Psychology, Dickinson College, Carlisle, Pennsylvania, USA.
Int J Eat Disord. 2021 Jul;54(7):1278-1282. doi: 10.1002/eat.23508. Epub 2021 Mar 24.
To better understand those patients with anorexia nervosa who do not show early response to treatment and are likely to have poorer outcome.
From an existing data set of 187 patients with anorexia nervosa across 22 eating disorder outpatient services in the United Kingdom, participants who had started treatment and had at least one body mass index (BMI) observation in the first 6 weeks of treatment were eligible for these secondary analyses (N = 65), a latent class analysis of BMI change over the first 6 weeks of treatment. Fifty-six patients showed no early change in BMI. We used logistic regression to examine predictors of good outcome in the 40 participants who had 12-month follow-up data. Predictors included global EDE-Q, negative affect (Depression, Anxiety, and Stress Scales) and functional impairment (Work and Social Adjustment Scale).
Good outcome was achieved by 23% of patients and remission by 15%. Good outcome was predicted by less functional impairment at baseline.
Further work that can identify sub-groups of patients with anorexia nervosa who do not achieve good outcome after treatment will inform the development of targeted engagement approaches.
更好地了解那些对治疗早期无反应且预后较差的神经性厌食症患者。
从英国 22 个饮食失调门诊服务机构的 187 名神经性厌食症患者的现有数据集中，选取在治疗开始后前 6 周内至少有一次体重指数（BMI）观察结果的患者（N=65）进行这些二次分析，即对治疗前 6 周内 BMI 变化进行潜在类别分析。56 名患者的 BMI 没有早期变化。我们使用逻辑回归分析了在有 12 个月随访数据的 40 名参与者中，哪些因素能预测良好的预后。预测因子包括全球 EDE-Q、负性情绪（抑郁、焦虑和压力量表）和功能障碍（工作和社会调整量表）。
23%的患者取得了良好的预后，15%的患者达到了缓解。良好的预后由基线时较低的功能障碍预测。
进一步的工作可以确定治疗后未取得良好预后的神经性厌食症患者的亚组，从而为有针对性的治疗方法提供依据。
