Bentz Mette, Pedersen Signe Holm, Moslet Ulla
Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Bispebjerg Bakke 30, 2400, Copenhagen NV, Denmark.
J Eat Disord. 2021 Oct 29;9(1):141. doi: 10.1186/s40337-021-00498-2.
Family-based treatment (FBT) has demonstrated efficacy for anorexia nervosa (AN) in youth in randomized, controlled trials. It is important to assess if it shows a similar effectiveness when implemented in standard care.
To evaluate outcomes of FBT for restrictive-type eating disorders, delivered as standard care in a public mental health service. Outcomes are remission, frequency of hospital admissions and day-patient treatment, and frequency of other adaptations within 12 months from commencement of treatment. Second, to compare the collaborative clinical decisions of successful treatment in standard care made by family therapist at the end of treatment, with more objective definitions of recovery.
The design is a prospective, uncontrolled study of a consecutive series of patients with restrictive-type eating disorders, treated with FBT in a specialty unit at the Child and Adolescent Mental Health Centre in the Capital Region of Denmark.
FBT was successfully completed within 12 months by 57% of participants, and 47% completed with 20 sessions or fewer. Weight restoration was achieved by 75% within 12 months, and 46% achieved both normalisation of body weight and behavioural symptoms of AN within 12 months. A total of 20% needed intensified treatment. All aspects of remission were often not present simultaneously, and the collaborative clinical decisions of successful treatment only partly aligned with other parameters of remission.
FBT showed good results when implemented as standard care, and it can be adapted to the specifics of local service organisation without compromising effectiveness.
在随机对照试验中，基于家庭的治疗（FBT）已证明对青少年神经性厌食症（AN）有效。评估其在标准护理中实施时是否显示出类似的效果很重要。
评估在公共心理健康服务中作为标准护理提供的FBT对限制型饮食失调症的治疗效果。结果包括缓解情况、住院和日间住院治疗的频率，以及治疗开始后12个月内其他调整的频率。其次，比较治疗结束时家庭治疗师在标准护理中做出的成功治疗的协作临床决策与更客观的康复定义。
该设计是一项对一系列连续性限制型饮食失调症患者进行的前瞻性、非对照研究，这些患者在丹麦首都地区儿童和青少年心理健康中心的一个专科单位接受FBT治疗。
57%的参与者在12个月内成功完成FBT，47%的参与者完成了20次或更少的治疗。75%的患者在12个月内实现了体重恢复，46%的患者在12个月内实现了体重正常化和神经性厌食症的行为症状改善。共有20%的患者需要强化治疗。缓解的各个方面通常并非同时出现，成功治疗的协作临床决策仅部分与其他缓解参数一致。
FBT作为标准护理实施时显示出良好的效果，并且可以根据当地服务机构的具体情况进行调整而不影响疗效。
