Østgård Beate, Nordahl Gunn Julie D, Strandheim Arve, Nordahl Hans M
Department of Child and Adolescent Psychiatry, St. Olavs University Hospital, Trondheim, Norway.
Child and Adolescent Clinic, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway.
J Eat Disord. 2025 May 26;13(1):91. doi: 10.1186/s40337-025-01272-4.
The incidence of anorexia nervosa (AN) has increased over the past decade, particularly among school-aged children. Family-based therapy (FBT), which focuses on parental management and control, is the recommended and standard treatment for adolescents with AN. While FBT promotes weight gain and improved parent‒child interactions, it does not directly address the adolescents' cognitive change, which could make them vulnerable to relapse. Metacognitive therapy is scarcely studied in AN, and this trial tested its feasibility and long-term effects for adolescents with AN.
This phase II trial included 14 adolescents with AN in an A‒B design. Medical tests and diagnostic assessments were conducted before and after treatment. Assessments were conducted before treatment, by end of treatment and at 12 months after end of treatment. We integrated family-based treatment and metacognitive therapy for patient intervention and parental guidance.
At posttreatment, 13 of the 14 patients no longer met the diagnostic criteria for AN. There were significant increases in percentage expected body weight and reductions in emotional and cognitive symptoms. One patient continued to have eating disorder symptoms at posttreatment and withdrew before follow-up. No significant changes were observed in areas of family conflict or parent‒child communication. The treatment was well tolerated and deemed meaningful by both parents and patients. No adverse events or rehospitalization occurred during the 12 month follow-up period. Data collection was challenging, especially with respect to patients' disclosure of family interactions and symptoms.
The trial revealed positive effects posttreatment at the 12 month follow-up for 13 of 14 participants with AN. The treatment was well tolerated with no adverse effects. Despite the small sample size and lack of control, the results suggest that larger-scale trials of this intervention are warranted.
The study has been approved as a clinical and quality audit of the delivered clinical service registered by the institutional research board at Levanger Hospital HF (IRB-13672).
在过去十年中，神经性厌食症（AN）的发病率有所上升，尤其是在学龄儿童中。以家庭为基础的治疗（FBT）侧重于父母的管理和控制，是推荐用于患有AN的青少年的标准治疗方法。虽然FBT能促进体重增加并改善亲子互动，但它并未直接解决青少年的认知变化问题，而这可能使他们容易复发。元认知疗法在AN研究中几乎未被涉及，本试验对其用于患有AN的青少年的可行性和长期效果进行了测试。
本II期试验采用A-B设计，纳入了14名患有AN的青少年。在治疗前后进行了医学检查和诊断评估。评估在治疗前、治疗结束时以及治疗结束后12个月进行。我们将基于家庭的治疗和元认知疗法相结合，用于患者干预和家长指导。
治疗后，14名患者中有13名不再符合AN的诊断标准。预期体重百分比显著增加，情绪和认知症状减轻。一名患者在治疗后仍有饮食失调症状，并在随访前退出。在家庭冲突或亲子沟通方面未观察到显著变化。该治疗耐受性良好，父母和患者均认为有意义。在12个月的随访期内未发生不良事件或再次住院情况。数据收集具有挑战性，尤其是在患者披露家庭互动和症状方面。
该试验显示，在12个月的随访中，14名患有AN的参与者中有13名在治疗后产生了积极效果。该治疗耐受性良好，无不良影响。尽管样本量小且缺乏对照，但结果表明有必要对这种干预措施进行更大规模的试验。
该研究已被批准作为由勒旺厄医院HF的机构研究委员会注册的所提供临床服务的临床和质量审计（IRB-13672）。
