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青少年神经性厌食症的长期结局:家庭治疗公寓与儿童精神科住院治疗的比较

Long-Term Outcome of Adolescent Anorexia Nervosa: Family Treatment Apartments Compared With Child Psychiatric Inpatient Treatment.

作者信息

Wallin Ulf, Holmer Riitta

机构信息

Centre of Eating Disorders, Psychiatry Skåne, Lund, Sweden.

出版信息

Front Psychiatry. 2021 May 17;12:640622. doi: 10.3389/fpsyt.2021.640622. eCollection 2021.

Abstract

The family is rarely involved in treatment when the patient with anorexia nervosa (AN) is hospitalized. Family treatment apartment (FTA) represents an intervention that includes the family in the intensive treatment of AN. This study compares the short- and long-term outcomes of adolescents treated in FTA with those who received inpatient hospital care. In FTA, the parents are responsible for providing meal support, whereas in hospital care, the staff is responsible. Sixty-eight previous patients admitted during the period 1990-2009 participated in a follow-up, 43 from the FTA where the whole family is admitted for treatment and 25 from regular psychiatric inpatient care. The follow-up consisted of a personal meeting with structured interviews, measurement of height and weight, and self-rating questionnaires. Readmissions due to weight loss within 6 months from discharge were less common in the FTA group. At follow-up, 14.2 years after admission, there was no difference in eating disorder pathology between the groups. There were significantly lower scores on general psychiatric pathology and significantly higher scores on quality of life in the FTA group. The treatment in FTA aims to give the family the ability to handle AN when it is most challenging. FTA may thus provide a helpful context for treatment with a basic sense of security along with skills that could contribute to better general mental health at follow-up.

摘要

神经性厌食症(AN)患者住院时,其家庭很少参与治疗。家庭治疗公寓(FTA)是一种将家庭纳入AN强化治疗的干预措施。本研究比较了在FTA接受治疗的青少年与接受住院治疗的青少年的短期和长期治疗效果。在FTA中,父母负责提供饮食支持,而在住院治疗中,由工作人员负责。1990年至2009年期间收治的68例既往患者参与了随访,其中43例来自全家入住接受治疗的FTA,25例来自常规精神科住院治疗。随访包括一次结构化访谈的个人会面、身高和体重测量以及自评问卷。出院后6个月内因体重减轻再次入院的情况在FTA组中较少见。在入院14.2年后的随访中,两组之间的饮食失调病理情况没有差异。FTA组的一般精神病理得分显著更低,生活质量得分显著更高。FTA治疗旨在使家庭有能力在最具挑战性的时候应对AN。因此,FTA可能为治疗提供一个有益的环境,带来基本的安全感以及有助于随访时改善总体心理健康的技能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c1c/8165165/dd942ca00a9f/fpsyt-12-640622-g0001.jpg

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