Cambridgeshire and Peterborough NHS Foundation Trust, Elizabeth House, Fulbourn, CB21 5EF, UK.
National Institute for Health Research, Applied Research Collaboration East of England, Douglas House, 18 Trumpington Road, Cambridge, CB2 8AH, UK.
Eat Weight Disord. 2022 Aug;27(6):1953-1962. doi: 10.1007/s40519-021-01338-7. Epub 2021 Dec 1.
Eating disorder (ED) prevalence and illness severity is rapidly increasing. The complicated interplay of factors contributing to the maintenance of EDs, including family/carer influences, highlights the importance of carer interventions within ED treatment. Carer interventions demonstrate positive outcomes for carers themselves, though are also hypothesised to benefit the patient indirectly. A systematic review was conducted to greater understand the impact of carer interventions on ED patient outcomes.
Eight databases, including CINAHL, MEDLINE and PsychINFO, were systematically searched. Intervention studies for parent(s)/carer(s) of a patient with an ED were included, provided they reported outcomes for the patient. No publication date restrictions were set. Included studies were quality appraised.
Twenty-eight studies met inclusion for the review; all of which varied in intervention type, duration, content and setting. Patient diagnosis and treatment setting were mixed across studies, though the majority focused on Anorexia Nervosa within outpatient settings. Intervention content broadly included consideration of relationship issues and interactional patterns, psychoeducation, skill development, behavioural management, and peer support. Therapeutic models utilised were diverse, including but not limited to: family, interpersonal, cognitive, and psychodynamic approaches.
Several carer interventions showed positive outcomes for patients with EDs, with small group treatment formats being commonly used and proving effective through intervention content alongside a peer support element. Separate family therapy was suggested to be of equal efficacy, if not better, than family therapy alongside the patient. Recommendations for clinical practice and future research are considered.
1: Systematic review, evidence mostly obtained from randomised controlled trials.
饮食失调（ED）的患病率和疾病严重程度正在迅速上升。导致 ED 持续存在的各种因素之间的复杂相互作用，包括家庭/照顾者的影响，凸显了在 ED 治疗中进行照顾者干预的重要性。照顾者干预对照顾者本身有积极的效果，尽管也假设对患者有间接的好处。进行了一项系统评价，以更深入地了解照顾者干预对 ED 患者结果的影响。
系统地搜索了八个数据库，包括 CINAHL、MEDLINE 和 PsychINFO。纳入了针对 ED 患者的父母/照顾者的干预研究，只要它们报告了患者的结果。没有设置出版日期限制。纳入的研究进行了质量评估。
有 28 项研究符合综述纳入标准；所有研究在干预类型、持续时间、内容和设置方面都有所不同。患者的诊断和治疗环境在研究中各不相同，但大多数研究都集中在门诊环境中的神经性厌食症。干预内容广泛包括考虑关系问题和互动模式、心理教育、技能发展、行为管理和同伴支持。所使用的治疗模式多种多样，包括但不限于：家庭、人际、认知和心理动力学方法。
几种照顾者干预对 ED 患者有积极的效果，小组治疗形式通常被使用，并且通过干预内容和同伴支持元素证明是有效的。单独的家庭治疗被认为与患者一起进行家庭治疗同样有效，如果不是更好的话。考虑了临床实践和未来研究的建议。
1：系统评价，证据主要来自随机对照试验。
