A randomised controlled trial of three psychological treatments for anorexia nervosa
A randomised controlled trial of three psychological treatments for anorexia nervosa
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DOI：
10.1017/s0033291717001349
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发表时间：
2017-12-01
影响因子：
6.9
通讯作者：
Crosby, R. D.
中科院分区：
文献类型：
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作者：
Byrne, S.;Wade, T.;Crosby, R. D.
背景目前缺乏证据表明任何特定的心理治疗对成人神经性厌食症（AN）的疗效。本研究的目的是比较三种心理治疗AN：专家支持性临床管理，莫兹利模型神经性厌食症治疗成人和增强认知行为Therapy.Method一个多中心的随机对照试验进行了评估，在治疗前，中期和治疗后，以及6-和12个月的随访研究人员盲目治疗分配的结果。所有的分析都是意向治疗。120个符合AN诊断标准的个体从澳大利亚三个城市的门诊治疗机构招募，并在10个月内提供25-40次治疗。主要结果是体重指数（BMI）和进食障碍精神病理学。次要结果包括抑郁，焦虑，压力和心理社会impairment.Results治疗完成了60%的参与者和52.5%的总样本完成了12个月的随访。完成率在治疗之间没有差异。两种治疗在连续结局方面无显著差异;所有治疗均导致BMI、进食障碍精神病理学、一般精神病理学和心理社会损害的临床显著改善，并在随访期间得以维持。在达到健康体重方面，治疗组之间没有显著差异（平均值= 50%）或缓解（平均= 28.3%）在12个月的随访。结论研究结果增加了证据基础，这三个心理治疗的成人AN，但研究结果强调，需要继续努力，以改善这种疾病的门诊治疗。试验注册（ACTRN 12611000725965）http://www.anzctr.org.au/
Background There is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy.Method A multi-centre randomised controlled trial was conducted with outcomes assessed at pre-, mid- and post-treatment, and 6- and 12-month follow-up by researchers blind to treatment allocation. All analyses were intention-to-treat. One hundred and twenty individuals meeting diagnostic criteria for AN were recruited from outpatient treatment settings in three Australian cities and offered 25-40 sessions over a 10-month period. Primary outcomes were body mass index (BMI) and eating disorder psychopathology. Secondary outcomes included depression, anxiety, stress and psychosocial impairment.Results Treatment was completed by 60% of participants and 52.5% of the total sample completed 12-month follow-up. Completion rates did not differ between treatments. There were no significant differences between treatments on continuous outcomes; all resulted in clinically significant improvements in BMI, eating disorder psychopathology, general psychopathology and psychosocial impairment that were maintained over follow-up. There were no significant differences between treatments with regard to the achievement of a healthy weight (mean = 50%) or remission (mean = 28.3%) at 12-month follow-up.Conclusion The findings add to the evidence base for these three psychological treatments for adults with AN, but the results underscore the need for continued efforts to improve outpatient treatments for this disorder.Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN 12611000725965) http://www.anzctr.org.au/