Davey Emily, Bennett Sophie D, Bryant-Waugh Rachel, Micali Nadia, Takeda Andrea, Alexandrou Alexia, Shafran Roz
UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
J Eat Disord. 2023 Apr 4;11(1):56. doi: 10.1186/s40337-023-00775-2.
Feeding and eating disorders are associated with significant illness burden and costs, yet access to evidence-based care is limited. Low intensity psychological interventions have the potential to increase such access.
A systematic review and meta-analysis were conducted on the use of low intensity psychological interventions for the treatment of feeding and eating disorders. Studies comparing low intensity psychological interventions against high intensity therapies and non-eating disorder specific psychological interventions were included, as well as those with waiting list control arms. There were three primary outcomes: eating disorder psychopathology, diagnostic and statistical manual of mental disorders (DSM) severity specifier-related outcomes and rates of remission/recovery.
Thirty-three studies met the inclusion criteria, comprising 3665 participants, and 30 studies were included in the meta-analysis. Compared to high intensity therapies, low intensity psychological interventions were equivalent on reducing eating disorder psychopathology (g = - 0.13), more effective at improving DSM severity specifier-related outcomes (g = - 0.15), but less likely to achieve remission/recovery (risk ratio (RR) = 0.70). Low intensity psychological interventions were superior to non-eating disorder specific psychological interventions and waiting list controls across all three primary outcomes.
Overall, findings suggest that low intensity psychological interventions can successfully treat eating disorder symptoms. Few potential moderators had a statistically significant effect on outcome. The number of studies for many comparisons was low and the methodological quality of the studies was poor, therefore results should be interpreted with caution. More research is needed to establish the effectiveness of low intensity psychological interventions for children and young people, as well as for individuals with anorexia nervosa, avoidant/restrictive food intake disorder, pica and rumination disorder.
喂养与进食障碍会带来巨大的疾病负担和成本，但获得循证护理的机会有限。低强度心理干预有可能增加这种机会。
对低强度心理干预用于治疗喂养与进食障碍的情况进行了系统评价和荟萃分析。纳入了比较低强度心理干预与高强度治疗以及非进食障碍特异性心理干预的研究，以及设有等待名单对照组的研究。有三个主要结局：进食障碍精神病理学、《精神障碍诊断与统计手册》（DSM）严重程度相关结局以及缓解/康复率。
33项研究符合纳入标准，共3665名参与者，30项研究纳入荟萃分析。与高强度治疗相比，低强度心理干预在减轻进食障碍精神病理学方面效果相当（g = -0.13），在改善DSM严重程度相关结局方面更有效（g = -0.15），但实现缓解/康复的可能性较小（风险比（RR）= 0.70）。在所有三个主要结局方面，低强度心理干预均优于非进食障碍特异性心理干预和等待名单对照组。
总体而言，研究结果表明低强度心理干预能够成功治疗进食障碍症状。几乎没有潜在的调节因素对结局有统计学上的显著影响。许多比较的研究数量较少，且研究的方法学质量较差，因此对结果的解释应谨慎。需要更多研究来确定低强度心理干预对儿童和青少年以及神经性厌食症、回避/限制性食物摄入障碍、异食癖和反刍障碍患者的有效性。
