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使用《精神疾病诊断与统计手册》第5版缓解标准对神经性厌食症青少年进行住院治疗的短期结果

Short-Term Outcome of Inpatient Treatment for Adolescents with Anorexia Nervosa Using DSM-5 Remission Criteria.

作者信息

Mairhofer Dunja, Zeiler Michael, Philipp Julia, Truttmann Stefanie, Wittek Tanja, Skala Katrin, Mitterer Michaela, Schöfbeck Gabriele, Laczkovics Clarissa, Schwarzenberg Julia, Wagner Gudrun, Karwautz Andreas

机构信息

Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria.

出版信息

J Clin Med. 2021 Jul 20;10(14):3190. doi: 10.3390/jcm10143190.

Abstract

This study evaluated the short-term outcome of a multimodal inpatient treatment concept for adolescents with anorexia nervosa (AN). In this prospective observational study, a cohort of 126 female adolescents with AN (age range: 11-17, mean age: 14.83) was longitudinally followed from admission to discharge (average duration of stay: 77 days). We used gold-standard clinical interviews and self-report data, as well as DSM-5 remission criteria, to evaluate the treatment outcome. From admission to discharge, body-mass-index (BMI) significantly improved by 2.6 kg/m. Data from clinical interviews and self-reports yielded similar improvements in restraint eating and eating concerns (large effects). Lower effects were observed for variables assessing weight/shape concerns and drive for thinness. At discharge, 23.2% of patients showed full remission of AN, 31.3% partial remission, and 45.5% no remission according to DSM-5 criteria. Differences in remission groups were found regarding AN severity, age at admission, and use of antidepressant medication. Living with both parents, longer duration of inpatient treatment and the use of antipsychotic medication were significantly associated with higher BMI change. The findings provide evidence for the short-term effectiveness of our inpatient treatment concept. We recommend using DSM-5 based remission criteria to evaluate the treatment outcome to improve the comparability of studies.

摘要

本研究评估了针对神经性厌食症(AN)青少年的多模式住院治疗方案的短期效果。在这项前瞻性观察研究中,对126名患有AN的女性青少年(年龄范围:11 - 17岁,平均年龄:14.83岁)进行了从入院到出院的纵向随访(平均住院时间:77天)。我们使用了金标准临床访谈和自我报告数据,以及《精神疾病诊断与统计手册》第5版(DSM - 5)的缓解标准来评估治疗效果。从入院到出院,体重指数(BMI)显著改善了2.6 kg/m²。临床访谈和自我报告的数据显示,在克制饮食和饮食问题方面有类似的改善(效果显著)。在评估体重/体型关注和对瘦身的追求等变量方面,观察到的效果较小。根据DSM - 5标准,出院时,23.2%的患者AN完全缓解,31.3%部分缓解,45.5%未缓解。在缓解组之间,发现了关于AN严重程度、入院年龄和抗抑郁药物使用情况的差异。与父母双方同住、住院治疗时间较长以及使用抗精神病药物与较高的BMI变化显著相关。这些发现为我们的住院治疗方案的短期有效性提供了证据。我们建议使用基于DSM - 5的缓解标准来评估治疗效果,以提高研究的可比性。

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