Schoemaker C
Department of Clinical Psychology and Personality, University of Nijmegen, The Netherlands.
Int J Eat Disord. 1997 Jan;21(1):1-15. doi: 10.1002/(sici)1098-108x(199701)21:1<1::aid-eat1>3.0.co;2-r.
Early intervention has been suggested to be an important positive prognostic factor in the treatment of anorexia nervosa (AN). The treatment-outcome studies conducted thus far were systematically reviewed in search of evidence to confirm this suggestion.
An extensive search was conducted for treatment outcome studies specifically addressing the prognostic value of the duration of the illness. Thirty-three follow-up studies of eating disorders and AN in particular were subjected to nine "best-evidence" criteria for methodological soundness. Six of these studies were found to meet all of the criteria and thus considered in greater detail.
In four of these studies, the duration of illness was not found to be related to the treatment outcome. This is presumably because of the low variability in duration of illness found in these studies. In the two remaining studies, a negative relation between duration of illness and the outcome of treatment was reported. As a result of methodological shortcomings and a lack of control for potentially confounding variables, however, the prognostic value of early intervention could still not be estimated on the basis of these studies.
The prognostic value of early intervention in AN cannot be estimated on the basis of the treatment-outcome literature. Unfortunately, the duration of the illness and not the occurrence of early intervention is considered in most of the outcome studies of AN. In addition, a number of methodological shortcomings make it impossible to evaluate the prognostic value of early intervention.
早期干预被认为是神经性厌食症（AN）治疗中一个重要的积极预后因素。对迄今为止进行的治疗结果研究进行系统综述，以寻找证据证实这一观点。
广泛检索专门探讨疾病持续时间预后价值的治疗结果研究。对33项饮食失调尤其是神经性厌食症的随访研究，依据九条方法学合理性的“最佳证据”标准进行评估。发现其中六项研究符合所有标准，因此进行更详细的考量。
在其中四项研究中，未发现疾病持续时间与治疗结果相关。推测这是因为这些研究中疾病持续时间的变异性较低。在其余两项研究中，报告了疾病持续时间与治疗结果之间存在负相关。然而，由于方法学上的缺陷以及对潜在混杂变量缺乏控制，基于这些研究仍无法估计早期干预的预后价值。
基于治疗结果文献无法估计早期干预在神经性厌食症中的预后价值。遗憾的是，在大多数神经性厌食症的结果研究中，考虑的是疾病持续时间而非早期干预的发生情况。此外，一些方法学上的缺陷使得无法评估早期干预的预后价值。
