Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Italy.
Int J Eat Disord. 2024 Jul;57(7):1566-1575. doi: 10.1002/eat.24196. Epub 2024 Mar 14.
This study aimed to compare the effectiveness of an intensive treatment based on enhanced cognitive-behavioral therapy (CBT-E) in patients aged between 12 and 18 years with anorexia nervosa with a duration of illness <3 versus ≥3 years.
One hundred and fifty-nine consecutively treated patients (n = 122 with illness duration <3 years and n = 37 ≥ 3 years) were enrolled in a 20-week intensive CBT-E program. All patients underwent assessment at admission, end of treatment (EOT), and 20-week follow-up. The following measures were used: body mass index (BMI)-for-age percentile and percentage of expected body weight (EBW), Eating Disorder Examination Questionnaire, Brief Symptom Inventory, and Clinical Impairment Assessment.
Approximately 81% of eligible patients began the program, with over 80% successfully completing it. Patients with a longer or shorter duration of illness did not show significantly different treatment outcomes. In detail, BMI-for-age percentile and percentage of EBW outcomes were significantly improved from baseline to EOT, remaining stable until 20-week follow-up in both groups. Similarly, in both groups, scores for eating disorder psychopathology, general psychopathology, and clinical impairment decreased significantly at EOT and remained stable from EOT to follow-up. Furthermore, a substantial percentage of adolescents in both groups achieved a good BMI outcome at EOT and 20-week follow-up, with approximately 60% maintaining a full response at the latter time point.
These findings suggest that intensive CBT-E appears to be an effective treatment for severely ill adolescent patients with anorexia nervosa, regardless of whether the duration of illness is shorter or longer than 3 years.
Existing treatment outcome studies in adolescents, whether randomized controlled trials or longitudinal investigations, typically involve patients with less than 3 years of illness, while data on the treatment outcomes for adolescents with anorexia nervosa with an illness duration of 3 years or over is very limited. Our findings suggest that adolescents with anorexia nervosa, irrespective of the duration of their illness, can derive similar benefits from intensively CBT-E.
本研究旨在比较强化认知行为疗法（CBT-E）在病程<3 年和≥3 年的 12-18 岁青少年神经性厌食症患者中的疗效。
159 名连续治疗的患者（病程<3 年的 n=122，病程≥3 年的 n=37）入组参加 20 周强化 CBT-E 项目。所有患者在入院时、治疗结束时（EOT）和 20 周随访时进行评估。采用以下措施：体重指数（BMI）-年龄百分位数和预期体重百分比（EBW）、饮食障碍检查问卷、Brief Symptom Inventory 和临床损伤评估。
大约 81%符合条件的患者开始了该项目，其中超过 80%的患者成功完成了该项目。病程较长或较短的患者治疗结果无显著差异。具体而言，两组患者的 BMI-年龄百分位数和 EBW 百分比均从基线显著改善到 EOT，并在两组中均保持稳定至 20 周随访。同样，两组患者的饮食障碍心理病理学、一般心理病理学和临床损伤评分在 EOT 时显著下降，并在 EOT 至随访期间保持稳定。此外，两组中有相当比例的青少年在 EOT 和 20 周随访时达到了良好的 BMI 结果，大约 60%的人在后者时保持了完全反应。
这些发现表明，强化 CBT-E 似乎是一种有效的治疗严重青少年神经性厌食症患者的方法，无论病程是否短于或长于 3 年。
现有的青少年治疗结果研究，无论是随机对照试验还是纵向研究，通常涉及病程<3 年的患者，而关于病程 3 年或以上的青少年神经性厌食症患者的治疗结果数据非常有限。我们的发现表明，青少年神经性厌食症患者，无论病程长短，都可以从强化 CBT-E 中获得类似的益处。
