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接受家庭治疗的非典型神经性厌食症青少年的体重结果。

Weight outcomes for adolescents with atypical anorexia nervosa in family-based treatment.

作者信息

Quon Elizabeth C, Kelly Brynn M

机构信息

Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

IWK Health, Halifax, Nova Scotia, Canada.

出版信息

J Can Acad Child Adolesc Psychiatry. 2023 Aug;32(3):161-171. Epub 2023 Aug 1.

Abstract

BACKGROUND

Although over one-third of adolescents presenting with restrictive eating disorders have a history of being overweight, there is no evidence-based treatment for atypical anorexia nervosa (AAN). Family-Based Treatment (FBT) is a feasible treatment and is routinely applied to treat atypical anorexia nervosa in adolescents; however, identifying a treatment target weight within FBT for these patients is a challenge.

OBJECTIVE

This study aimed to 1) increase understanding regarding recommendations for weight gain versus weight stabilization in FBT for adolescents with AAN and 2) examine treatment outcomes in FBT for adolescents with AAN.

METHOD

Using a retrospective design, we reviewed the files of 41 patients with AAN who were referred for FBT at a pediatric eating disorder program located within a tertiary care health centre.

RESULTS

We found variability in recommendations for weight gain, with 56% of the sample recommended to gain weight and 44% recommended to stabilize weight. Baseline BMI for age appeared to be a key factor in establishing recommendations for weight gain. AAN patients in our sample gained a significant amount of weight across treatment, with those recommended to gain weight showing more weight gain during treatment. Forty-nine percent of the sample completed FBT; those patients displayed a mean of 10kg of weight gain during treatment.

CONCLUSIONS

Findings suggest that many patients gained weight during the course of FBT for AAN. Further study on weight changes during FBT for adolescents with AAN and increased diagnostic consistency for AAN will be important for this field.

摘要

背景

尽管超过三分之一患有限制性饮食失调的青少年有超重病史,但对于非典型神经性厌食症(AAN)尚无循证治疗方法。基于家庭的治疗(FBT)是一种可行的治疗方法,通常用于治疗青少年非典型神经性厌食症;然而,在FBT中为这些患者确定治疗目标体重是一项挑战。

目的

本研究旨在1)增进对FBT中AAN青少年体重增加与体重稳定建议的理解,以及2)研究FBT对AAN青少年的治疗效果。

方法

采用回顾性设计,我们回顾了在一家三级医疗保健中心的儿科饮食失调项目中被转诊接受FBT的41例AAN患者的病历。

结果

我们发现体重增加建议存在差异,56%的样本被建议增加体重,44%被建议稳定体重。年龄别基线BMI似乎是确定体重增加建议的关键因素。我们样本中的AAN患者在整个治疗过程中体重显著增加,那些被建议增加体重的患者在治疗期间体重增加更多。49%的样本完成了FBT;这些患者在治疗期间平均体重增加了10千克。

结论

研究结果表明,许多患者在AAN的FBT过程中体重增加。进一步研究AAN青少年在FBT期间的体重变化以及提高AAN的诊断一致性对该领域将很重要。

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