Randomized Clinical Trial of Parent-Focused Treatment and Family-Based Treatment for Adolescent Anorexia Nervosa
Randomized Clinical Trial of Parent-Focused Treatment and Family-Based Treatment for Adolescent Anorexia Nervosa
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DOI：
10.1016/j.jaac.2016.05.007
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发表时间：
2016-08-01
影响因子：
13.3
通讯作者：
Sawyer, Susan M.
中科院分区：
文献类型：
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作者：
Le Grange, Daniel;Hughes, Elizabeth K.;Sawyer, Susan M.
目的：目前针对青少年神经性厌食症（AN）的随机临床试验（RCT）较少。大多数涉及所有家庭成员的治疗支持有利的结果。然而，至少有2项随机对照试验表明，单独的父母和青少年会议可能是一样有效的联合治疗。本研究比较了以家庭为基础的治疗（FBT）和以父母为中心的治疗（PFT）的相对疗效。在PFT，治疗师会见了父母只，而护士monitorspatient.Method：参与者（N = 107）年龄在12至18岁，符合DSM第4版标准AN或部分AN被随机分配到FBT或PFT。在基线、治疗结束（EOT）以及治疗后6个月和12个月对参与者进行评估。治疗包括6个月内的18次门诊治疗。主要结局是缓解，定义为中位体重指数>= 95%，进食障碍检查总体评分在社区标准的1 SD内。（43% vs 22%; p = 0.016，比值比[OR] = 3.03，95% CI = 1.23-7.46），但在6个月时无统计学差异（PFT 39% vs FBT 22%; p = 0.053，OR = 2.48，CI = 0.989-6.22）或12个月随访（PFT 37% vs FBT 29%; p = 0.444，OR = 1.39，95% CI = 0.60-3.21）。几个治疗效果moderatcirs的主要outcome.Conclusion：在EOT，PFT是更有效的，比FBT在青少年AN带来缓解。然而，随访时PFT和FBT之间的缓解率差异无统计学意义。
Objective: There have been few randomized clinical trials (RCTs) for adolescents with anorexia nervosa (AN). Most of these posit that involving all family members in treatment supports favorable outcomes. However, at least 2 RCTs suggest that separate parent and adolescent sessions may be just as effective as conjoint treatment. This study compared the relative efficacy of family-based treatment (FBT) and parent-focused treatment (PFT). In PFT, the therapist meets with the parents only, while a nurse monitors the patient.Method: Participants (N = 107) aged 12 to 18 years and meeting DSM 4th Edition criteria for AN or partial AN were randomized to either FBT or PFT. Participants were assessed at baseline, end of treatment (EOT), and at 6 and 12 months posttreatment. Treatments comprised 18 outpatient sessions over 6 months. The primary outcome was remission, defined as >= 95% of median body mass index and Eating Disorder Examination Global Score within 1 SD of community norms.Results: Remission was higher in PFT than in FBT at EOT (43% versus 22%; p =.016, odds ratio [OR] = 3.03, 95% CI = 1.23-7.46), but did not differ statistically at 6-month (PFT 39% versus FBT 22%; p =.053, OR = 2.48, CI = 0.989-6.22), or 12-month (PFT 37% versus FBT 29%; p =.444, OR = 1.39, 95% CI = 0.60-3.21) follow-up. Several treatment effect moderatcirs of primary outcome were identified.Conclusion: At EOT, PFT was more efficacious than FBT in bringing about remission in adolescents with AN. However, differences in remission rates between PFT and FBT at follow-up were not statistically significant.