Enhanced cognitive-behavior therapy and family-based treatment for adolescents with an eating disorder: a non-randomized effectiveness trial

Autor:	Helene Keery, Ross D. Crosby, Sarah Eckhardt, Carolyn Martell, Riccardo Dalle Grave, Julie Lesser, Daniel Le Grange, Carol B. Peterson
Rok vydání:	2020
Předmět:	Pediatrics medicine.medical_specialty business.industry medicine.disease Avoidant/restrictive food intake disorder Clinical trial Psychiatry and Mental health Eating disorders Cohort medicine Median body Mass index medicine.symptom Underweight business Weight gain Applied Psychology
Zdroj:	Psychological Medicine. 52:2520-2530
ISSN:	1469-8978 0033-2917
DOI:	10.1017/s0033291720004407
Popis:	BackgroundFamily-based treatment (FBT) is an efficacious intervention for adolescents with an eating disorder. Evaluated to a lesser degree among adolescents, enhanced cognitive-behavior therapy (CBT-E) has shown promising results. This study compared the relative effectiveness of FBT and CBT-E, and as per manualized CBT-E, the sample was divided into alower weight[higher weightcohort (⩾90%mBMI).MethodParticipants (N= 97) aged 12–18 years, with a DSM-5 eating disorder diagnosis (largely restrictive, excluding Avoidant Restrictive Food Intake Disorder), and their parents, chose between FBT and CBT-E. Assessments were administered at baseline, end-of-treatment (EOT), and follow-up (6 and 12 months). Treatment comprised of 20 sessions over 6 months, except for thelower weightcohort where CBT-E comprised 40 sessions over 9–12 months. Primary outcomes were slope of weight gain and change in Eating Disorder Examination (EDE) Global Score at EOT.ResultsSlope of weight gain at EOT was significantly higher for FBT than for CBT-E (lower weight, est. = 0.597,s.e.= 0.096,p< 0.001;higher weight, est. = 0.495,s.e.= 0.83,p< 0.001), but not at follow-up. There were no differences in the EDE Global Score or most secondary outcome measures at any time-point. Several baseline variables emerged as potential treatment effect moderators at EOT. Choosing between FBT and CBT-E resulted in older and less well participants opting for CBT-E.ConclusionsResults underscore the efficiency of FBT to facilitate weight gain among underweight adolescents. FBT and CBT-E achieved similar outcomes in other domains assessed, making CBT-E a viable treatment for adolescents with an eating disorder.Clinical Trial Registration Information:Treatment Outcome in Eating Disorders;https://clinicaltrials.gov/; NCT03599921.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::09afe317d10d83c20e494c40ac54d505 https://doi.org/10.1017/s0033291720004407 Zobrazit plný text záznamu