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成人进食障碍强化治疗选择的系统评价和荟萃分析。

A systematic review and meta-analysis of intensive treatment options for adults with eating disorders.

机构信息

Department of Neuroscience, Monash University, Melbourne, Victoria, Australia.

Flinders University, Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia.

出版信息

Clin Psychol Rev. 2023 Dec;106:102354. doi: 10.1016/j.cpr.2023.102354. Epub 2023 Oct 26.

Abstract

Eating disorders (EDs) are complex conditions with one of the highest mortality rates among psychiatric illnesses. While outpatient evidence-based treatments for EDs in adults exist, there is often utilisation of more intensive interventions as part of treatment. However, a comprehensive analysis of the impacts of intensive treatment (inpatient, residential and day program) on physical and psychosocial outcomes is lacking. Thus, the current systematic review and meta-analysis aimed to investigate the effectiveness of intensive treatments in adults with EDs for the outcomes of body mass index (BMI), disordered eating, depression, and quality of life, as well as a moderation analysis investigating a range of clinical characteristics. Overall, 62 studies were included in the meta-analysis. The results revealed that intensive treatment in adults yielded significant improvements in BMI (for underweight patients), disordered eating, depression, and quality of life. Treatment setting, length of stay and geographical region of the study all served as moderators for disordered eating and depression. Nevertheless, given the high heterogeneity in the meta- and moderation analyses, these results should be interpreted with caution. Future high-quality research is needed to determine the most beneficial elements of intensive treatment (compared to outpatient) in adults with EDs.

摘要

进食障碍(EDs)是一种复杂的病症,其死亡率在精神疾病中是最高的之一。虽然针对成人 ED 已经存在基于门诊的循证治疗方法,但在治疗过程中通常会采用更密集的干预措施。然而,目前缺乏对密集治疗(住院、住院和日间治疗)对身体和心理社会结果的全面分析。因此,目前的系统评价和荟萃分析旨在调查密集治疗对 ED 成人患者体重指数(BMI)、饮食紊乱、抑郁和生活质量的影响,并对一系列临床特征进行调节分析。总体而言,共有 62 项研究纳入了荟萃分析。结果表明,密集治疗可显著改善成人 BMI(对于体重不足的患者)、饮食紊乱、抑郁和生活质量。治疗环境、住院时间和研究的地理位置均为饮食紊乱和抑郁的调节因素。然而,鉴于荟萃分析和调节分析中的高度异质性,这些结果应谨慎解释。需要进行高质量的未来研究,以确定密集治疗(与门诊相比)对 ED 成人患者最有益的元素。

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