A Randomized controlled comparison of family-based treatment and supportive psychotherapy for adolescent bulimia nervosa
A Randomized controlled comparison of family-based treatment and supportive psychotherapy for adolescent bulimia nervosa
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DOI：
10.1001/archpsyc.64.9.1049
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发表时间：
2007-09-01
影响因子：
--
通讯作者：
Leventhal, Bennett L.
中科院分区：
文献类型：
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作者：
le Grange, Daniel;Crosby, Ross D.;Leventhal, Bennett L.
内容：青少年神经性贪食症的循证治疗试验在很大程度上是不存在的。目的：评价家庭治疗（FBT）和支持性心理治疗（SPT）对青少年神经性贪食症的相对疗效。设计：随机对照试验。设置：芝加哥大学，从2001年4月1日至2006年6月30日。参与者：80例患者，年龄在12至19岁，与DSM-IV诊断神经性贪食症或部分贪食症nervosa.Interventions的严格定义：20门诊访问超过6个月的FBT或SPT。参与者随访6个月posttreatment.Main结果测量：从暴饮暴食和清除发作的饮食失调检查衡量的禁欲。次要结果的措施是进食障碍检查暴饮暴食和清洗频率和进食障碍检查子量表scores.Results：41例患者被分配到FBT和39 SPT。治疗后的分类结果显示，接受FBT的患者（16例[39%]）比接受SPT的患者（7例[18%]）明显更多（P=. 001）。049）。在6个月随访时，禁欲的患者略少;然而，FBT与SPT的差异在统计学上是有利的（12例患者[29%] vs 4例患者[10%]; P=. 05）。基于随机回归分析的次要结果评估显示，FBT对所有进食病理特征指标的主要影响均有利于FBT（P=. 003至P =。结论：在治疗后和6个月随访时，以家庭为基础的治疗在临床和统计学上均优于SPT。与SPT相比，接受FBT的患者核心贪食症症状的减轻也更迅速。
Context: Evidenced-based treatment trials for adolescents with bulimia nervosa are largely absent.Objective: To evaluate the relative efficacy of family-based treatment (FBT) and supportive psychotherapy (SPT) for adolescents with bulimia nervosa.Design: Randomized controlled trial.Setting: The University of Chicago from April 1, 2001, through June 30, 2006.Participants: Eighty patients, aged 12 to 19 years, with a DSM-IV diagnosis of bulimia nervosa or a strict definition of partial bulimia nervosa.Interventions: Twenty outpatient visits over 6 months of FBT or SPT. Participants were followed up at 6months posttreatment.Main Outcome Measures: Abstinence from binge-and-purge episodes as measured by the Eating Disorder Examination. Secondary outcome measures were Eating Disorder Examination binge-and-purge frequency and Eating Disorder Examination subscale scores.Results: Forty-one patients were assigned to FBT and 39 to SPT. Categorical outcomes at posttreatment demonstrated that significantly more patients receiving FBT (16 [39%]) were binge-and-purge abstinent compared with those receiving SPT (7 [18%]) (P=. 049). Somewhat fewer patients were abstinent at the 6-month follow-up; however, the difference was statistically in favor of FBT vs SPT ( 12 patients [29%] vs 4 patients [10%]; P=. 05). Secondary outcome assessment, based on random regression analysis, revealed main effects in favor of FBT on all measures of eating pathological features ( P=. 003 to P =. 03 for all).Conclusions: Family-based treatment showed a clinical and statistical advantage over SPT at posttreatment and at 6-month follow-up. Reduction in core bulimic symptoms was also more immediate for patients receiving FBT vs SPT.