Calugi Simona, Chimini Mirko, Dalle Grave Anna, Cattaneo Gianmatteo, Conti Maddalena, Dalle Grave Riccardo
Department of Eating and Weight Disorders, Villa Garda Hospital, Via Monte Baldo, 89, 37016 Garda, VR, Italy.
Nutrients. 2025 Aug 23;17(17):2731. doi: 10.3390/nu17172731.
(1) Background: This study aimed to identify baseline demographic, clinical, and psychosocial predictors of treatment response in adolescents with anorexia nervosa (AN) undergoing an intensive 20-week enhanced cognitive behavioral therapy (CBT-E) program, which included inpatient and day patient phases. Treatment outcomes were assessed at the end of intensive treatment (EOIT) and at a 20-week follow-up. (2) Methods: A prospective cohort of 68 adolescents under the age of 16 consecutively admitted to intensive CBT-E was evaluated. Baseline measures included body mass index (BMI)-for-age percentiles, percentage of expected body weight (%EBW), eating disorder psychopathology (EDE-Q), general psychopathology, and functional impairment. (3) Results: Of those who began treatment, 83.4% completed the program and 70.2% were available for follow-up assessment. Based on intent-to-treat analysis, 94.1% achieved a "good BMI outcome" and 73.5% met criteria for "full response" at EOIT. At follow-up, 64.7% maintained a good BMI and 55.9% sustained a full response. Completers' analysis indicated that baseline body weight, clinical impairment, general psychopathology, and weight regain influenced treatment outcomes. However, no baseline demographic or clinical variables predicted treatment completion or outcome at either time point at intention-to-treat analysis, except that younger age at admission was linked to higher eating disorder psychopathology at follow-up. (4) Conclusions: In treatment completers, certain baseline clinical factors and weight regain influenced outcomes, while in the full sample, younger age predicted greater residual psychopathology at follow-up. These findings, if confirmed, emphasize the need for early intervention, focused support for weight regain, and potential adaptations of CBT-E for early adolescents.
(1) 背景：本研究旨在确定接受为期20周强化认知行为疗法（CBT-E）项目（包括住院和日间住院阶段）的神经性厌食症（AN）青少年患者治疗反应的基线人口统计学、临床和心理社会预测因素。在强化治疗结束时（EOIT）和20周随访时评估治疗结果。(2) 方法：对连续入院接受强化CBT-E治疗的68名16岁以下青少年进行前瞻性队列研究。基线测量包括年龄别体重指数（BMI）百分位数、预期体重百分比（%EBW）、饮食失调精神病理学（EDE-Q）、一般精神病理学和功能损害。(3) 结果：开始治疗的患者中，83.4%完成了该项目，70.2%可进行随访评估。基于意向性分析，94.1%在EOIT时达到了“良好的BMI结果”，73.5%符合“完全缓解”标准。在随访时，64.7%维持了良好的BMI，55.9%持续完全缓解。完成者分析表明，基线体重、临床损害、一般精神病理学和体重恢复影响治疗结果。然而，在意向性分析中，没有基线人口统计学或临床变量在任何一个时间点预测治疗完成或结果，除了入院时年龄较小与随访时较高的饮食失调精神病理学相关。(4) 结论：在治疗完成者中，某些基线临床因素和体重恢复影响结果，而在整个样本中，年龄较小预测随访时更大的残留精神病理学。这些发现若得到证实，强调了早期干预、对体重恢复的针对性支持以及对早期青少年调整CBT-E的必要性。
