The Impact of Inpatient Multimodal Treatment or Family-Based Treatment on Six-Month Weight Outcomes in Youth with Anorexia Nervosa: A Naturalistic, Cross-Continental Comparison.
The Impact of Inpatient Multimodal Treatment or Family-Based Treatment on Six-Month Weight Outcomes in Youth with Anorexia Nervosa: A Naturalistic, Cross-Continental Comparison.
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DOI：
10.3390/nu14071396
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发表时间：
2022-03-27
期刊：
影响因子：
5.9
通讯作者：
Haas, Verena
中科院分区：
文献类型：
--
作者：
Nadler, Janine;Correll, Christoph U.;Le Grange, Daniel;Accurso, Erin C.;Haas, Verena
关键词：
在美国，以家庭为基础的治疗（FBT）与住院医疗稳定的需要是领先的循证治疗青少年神经性厌食症（AN）。在欧洲大陆，如果先前的门诊治疗不充分，则通常以体重恢复为目标的住院多模式治疗，然后是门诊治疗（IMT）是标准治疗。我们的目的是使用自然治疗数据比较接受FBT（美国）与IMT（德国）的青少年在6个月内每周体重增加和住院天数。为了产生相似的12-18岁青年亚组，纳入标准是70-85之间的百分比中位数BMI（%mBMI）和限制性AN亚型。比较体重增加和住院天数，在多元线性回归分析（MLRA）中进一步调整基线组差异。样本在基线%mBMI上存在差异（FBT [n = 71]，90.5 ± 12.8; IMT [n = 29]，78.3 ± 9.1，p < 0.05）。在基线%mBMI相当的亚组中，6个月内每周体重增加相似（MLRA后FBT [n = 21]：0.35 ± 0.18 kg/周; IMT [n = 20]：0.30 ± 0.18，p = 0.390，p = 0.166），但FBT的住院天数更少（MLRA前后FBT [n = 7]：4 ± 6天，IMT [n = 20]：121 ± 42天，p < 0.0001）。FBT可能对目前接受IMT的AN青少年亚组有效，但需要在同一医疗保健系统中进行头对头研究。
In the USA, family-based treatment (FBT) with inpatient medical stabilization as needed is the leading evidence-based treatment for youth with anorexia nervosa (AN). In continental Europe, typically inpatient multimodal treatment targeting weight recovery followed by outpatient care (IMT) is standard care, if prior outpatient treatment was not sufficient. Our aim was to compare weekly weight gain and hospital days over six months for adolescents receiving FBT (USA) versus IMT (Germany) using naturalistic treatment data. To yield similar subgroups of youth aged 12–18 years, inclusion criteria were a percent median BMI (%mBMI) between 70–85 and the restrictive AN subtype. Weight gain and hospital days were compared, adjusted further in a multiple linear regression analysis (MLRA) for baseline group differences. Samples differed on baseline %mBMI (FBT [n = 71], 90.5 ± 12.8; IMT [n = 29], 78.3 ± 9.1, p < 0.05). In subgroups with comparable baseline %mBMI, the weekly weight gain over 6 months was similar (FBT [n = 21]: 0.35 ± 0.18 kg/week; IMT [n = 20]: 0.30 ± 0.18, p = 0.390, p = 0.166 after MLRA), but achieved fewer hospital days in FBT (FBT [n = 7]: 4 ± 6 days, IMT [n = 20]: 121 ± 42 days, p < 0.0001 before and after MLRA). FBT may be effective for a subgroup of adolescents with AN currently receiving IMT, but head-to-head studies in the same healthcare system are needed.
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