Psychological Treatment for Anorexia Nervosa: A Meta-Analysis of Standardized Mean Change
Psychological Treatment for Anorexia Nervosa: A Meta-Analysis of Standardized Mean Change
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DOI：
10.1159/000322360
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发表时间：
2011-01-01
影响因子：
22.8
通讯作者：
Zeeck, Almut
中科院分区：
文献类型：
--
作者：
Hartmann, Armin;Weber, Stefanie;Zeeck, Almut
背景：针对德国饮食失调治疗指南，对神经性厌食症（anorexia神经性厌食症，AN）的心理治疗文献进行系统回顾。由于随机临床试验的常规荟萃分析被证明是不可能的，因此我们对所有可用的临床试验进行了回顾，并对标准化平均变化评分进行了统计整合。研究问题包括治疗技术和设置的不同效果，以及确定哪些体重会增加。方法：在广泛的文献检索后，选择研究，由3位独立评分者进行评分。体重增加作为主要结局标准转化为标准化平均变化评分。检验效应量的同质性。结果：57项研究包含84个治疗组和2273名患者可以被纳入。研究的质量差别很大。发现的最大偏差是选择性地报告完井或失败，而不是意向治疗样本。在治疗环境、技术或患者特征方面，效应量之间没有显著差异。如果考虑到治疗时间，住院治疗比门诊治疗产生更快的体重增加。结论：该研究描述了体重增加，可以达到门诊和住院设置。对于某种治疗技术、设置或程序，它没有产生显著的结果。AN的心理治疗指南仍然依赖于较低水平的证据。巴塞尔S. Karger股份有限公司版权所有
Background: For the German treatment guidelines for eating disorders, the literature on psychological treatment of anorexia nervosa (AN) was reviewed systematically. As a common meta-analysis of randomized clinical trials proved to be impossible, a review of all available clinical trials was conducted, statistically integrating standardized mean change scores. Research questions comprised differential effects of therapeutic techniques and settings as well as determining which weight gains could be expected. Methods: After an extensive literature search, studies were selected, rated by 3 independent raters. Weight gain as the main outcome criterion was transformed into standardized mean change scores. Effect sizes were checked for homogeneity. Results: 57 studies containing 84 treatment arms and 2,273 patients could be integrated. Studies differed considerably in quality. The strongest bias identified was reporting selectively on completers or failures, versus intention-to-treat samples. No significant differences between effect sizes could be identified concerning treatment setting, technique or patient characteristics. If treatment time is taken into account, inpatient treatment produced a faster weight gain than outpatient treatment. Conclusion: The study describes weight gains which can be reached in outpatient and inpatient settings. It yielded no salient results speaking for a certain therapy technique, setting or procedure. Treatment guidelines for psychological treatment of AN still have to rely on lower level evidence. Copyright (C) 2011 S. Karger AG, Basel