Anorexia nervosa treatment: A systematic review of randomized controlled trials

International Journal of Eating Disorders - Tập 40 Số 4 - Trang 310-320 - 2007
Cynthia M. Bulik1,2, Nancy D Berkman3, Kimberly A Brownley2, Jan Sedway2, Kathleen N Lohr3
1Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
2Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
3Research Triangle Institute-UNC Evidence-Based Practice Center, Research Triangle Park, North Carolina

Tóm tắt

AbstractObjective:

The RTI International‐University of North Carolina at Chapel Hill Evidence‐based Practice Center (RTI‐UNC EPC) systematically reviewed evidence on efficacy of treatment for anorexia nervosa (AN), harms associated with treatments, factors associated with treatment efficacy, and differential outcome by sociodemographic characteristics.

Method:

We searched six major databases for studies on the treatment of AN from 1980 to September 2005, in all languages against a priori inclusion/exclusion criteria focusing on eating, psychiatric or psychological, or biomarker outcomes.

Results:

Thirty‐two treatment studies involved only medications, only behavioral interventions, and medication plus behavioral interventions for adults or adolescents. The literature on medication treatments and behavioral treatments for adults with AN is sparse and inconclusive. Cognitive behavioral therapy may reduce relapse risk for adults with AN after weight restoration, although its efficacy in the underweight state remains unknown. Variants of family therapy are efficacious in adolescents, but not in adults.

Conclusion:

Evidence for AN treatment is weak; evidence for treatment‐related harms and factors associated with efficacy of treatment are weak; and evidence for differential outcome by sociodemographic factors is nonexistent. Attention to sample size and statistical power, standardization of outcome measures, retention of patients in clinical trials, and developmental differences in treatment appropriateness and outcome is required. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007

Từ khóa


Tài liệu tham khảo

10.1002/eat.10261

Berkman N, 2006, Management of eating disorders

West S, 2002, Systems to rate the strength of scientific evidence. Evidence report, Technology Assessment No. 47

Greer N, 2000, A practical approach to evidence grading, Jt Comm J Qual Improv, 26, 700

10.1192/bjp.144.3.288

10.1002/eat.10235

10.1016/S0278-5846(01)00174-9

10.1159/000119214

10.1016/S0924-977X(02)00058-5

10.1002/1098-108X(199505)17:4<347::AID-EAT2260170406>3.0.CO;2-K

10.1007/BF03341582

10.1002/eat.10246

10.1192/bjp.151.2.185

10.1192/bjp.139.6.533

10.1002/(SICI)1098-108X(200007)28:1<101::AID-EAT12>3.0.CO;2-V

10.1002/1098-108X(199212)12:4<347::AID-EAT2260120402>3.0.CO;2-W

10.1097/00004583-199912000-00008

10.1176/ajp.155.4.548

10.1089/cap.2000.10.3

10.1016/S0006-3223(00)01013-1

10.1001/archpsyc.1986.01800020087011

10.1097/00004714-198502000-00003

10.1210/jc.80.3.898

10.1210/jc.2004-1181

10.1002/1098-108X(199404)15:3<251::AID-EAT2260150308>3.0.CO;2-#

10.1176/appi.ajp.160.11.2046

10.1176/appi.ajp.162.4.741

10.1016/0005-7967(89)90087-9

10.1016/0005-7967(94)00070-Z

10.1192/bjp.178.3.216

10.1111/1469-7610.00660

10.1097/01.chi.0000161647.82775.0a

10.1177/070674370004500208

10.1002/1098-108X(199403)15:2<165::AID-EAT2260150208>3.0.CO;2-0

10.1097/00004703-199404000-00008

10.1001/archpsyc.1987.01800240021004

10.1002/1098-108X(199505)17:4<313::AID-EAT2260170402>3.0.CO;2-8

10.1192/bjp.159.3.325

10.1001/archpsyc.1997.01830230063008

Klerman G, 1984, Interpersonal Psychotherapy of Depression

Fairburn CG, 1993, New Applications of Interpersonal Psychotherapy, 355

Lock J, 2001, Treatment Manual for Anorexia Nervosa: A Family‐Based Approach

10.7326/0003-4819-143-6-200509200-00006

10.1001/archpsyc.62.7.776