Daniel Le Grange1, Elizabeth K Hughes2, Andrew Court3, Michele Yeo3, Ross D Crosby4, Susan M Sawyer5. 1. University of Melbourne, Australia; University of California, San Francisco; and The University of Chicago, IL (emeritus). Electronic address: daniel.legrange@ucsf.edu. 2. University of Melbourne and Murdoch Childrens Research Institute, Australia. 3. Centre for Adolescent Health, Royal Children's Hospital. 4. Neuropsychiatric Research Institute, Fargo, ND, and University of North Dakota School of Medicine and Health Sciences, Fargo. 5. University of Melbourne, Centre for Adolescent Health, Royal Children's Hospital, and Murdoch Childrens Research Institute, Melbourne.
Abstract
OBJECTIVE: There have been few randomized clinical trials (RCTs) for adolescents with anorexia nervosa (AN). Most of these posit that involving all family members in treatment supports favorable outcomes. However, at least 2 RCTs suggest that separate parent and adolescent sessions may be just as effective as conjoint treatment. This study compared the relative efficacy of family-based treatment (FBT) and parent-focused treatment (PFT). In PFT, the therapist meets with the parents only, while a nurse monitors the patient. METHOD: Participants (N = 107) aged 12 to 18 years and meeting DSM 4(th)Edition criteria for AN or partial AN were randomized to either FBT or PFT. Participants were assessed at baseline, end of treatment (EOT), and at 6 and 12 months posttreatment. Treatments comprised 18 outpatient sessions over 6 months. The primary outcome was remission, defined as ≥95% of median body mass index and Eating Disorder Examination Global Score within 1 SD of community norms. RESULTS:Remission was higher in PFT than in FBT at EOT (43% versus 22%; p = .016, odds ratio [OR] = 3.03, 95% CI = 1.23-7.46), but did not differ statistically at 6-month (PFT 39% versus FBT 22%; p = .053, OR = 2.48, CI = 0.989-6.22), or 12-month (PFT 37% versus FBT 29%; p = .444, OR = 1.39, 95% CI = 0.60-3.21) follow-up. Several treatment effect moderators of primary outcome were identified. CONCLUSION: At EOT, PFT was more efficacious than FBT in bringing about remission in adolescents with AN. However, differences in remission rates between PFT and FBT at follow-up were not statistically significant. CLINICAL TRIAL REGISTRATION INFORMATION: A Randomised Controlled Trial of Two Forms of Family-Based Treatment and the Effect on Percent Ideal Body Weight and Eating Disorders Symptoms in Adolescent Anorexia Nervosa; http://www.anzctr.org.au/; ACTRN12610000216011.
RCT Entities:
OBJECTIVE: There have been few randomized clinical trials (RCTs) for adolescents with anorexia nervosa (AN). Most of these posit that involving all family members in treatment supports favorable outcomes. However, at least 2 RCTs suggest that separate parent and adolescent sessions may be just as effective as conjoint treatment. This study compared the relative efficacy of family-based treatment (FBT) and parent-focused treatment (PFT). In PFT, the therapist meets with the parents only, while a nurse monitors the patient. METHOD:Participants (N = 107) aged 12 to 18 years and meeting DSM 4(th)Edition criteria for AN or partial AN were randomized to either FBT or PFT. Participants were assessed at baseline, end of treatment (EOT), and at 6 and 12 months posttreatment. Treatments comprised 18 outpatient sessions over 6 months. The primary outcome was remission, defined as ≥95% of median body mass index and Eating Disorder Examination Global Score within 1 SD of community norms. RESULTS: Remission was higher in PFT than in FBT at EOT (43% versus 22%; p = .016, odds ratio [OR] = 3.03, 95% CI = 1.23-7.46), but did not differ statistically at 6-month (PFT 39% versus FBT 22%; p = .053, OR = 2.48, CI = 0.989-6.22), or 12-month (PFT 37% versus FBT 29%; p = .444, OR = 1.39, 95% CI = 0.60-3.21) follow-up. Several treatment effect moderators of primary outcome were identified. CONCLUSION: At EOT, PFT was more efficacious than FBT in bringing about remission in adolescents with AN. However, differences in remission rates between PFT and FBT at follow-up were not statistically significant. CLINICAL TRIAL REGISTRATION INFORMATION: A Randomised Controlled Trial of Two Forms of Family-Based Treatment and the Effect on Percent Ideal Body Weight and Eating Disorders Symptoms in Adolescent Anorexia Nervosa; http://www.anzctr.org.au/; ACTRN12610000216011.
Authors: Ginger E Nicol; Rachel Kolko; Eric J Lenze; Michael D Yingling; J Philip Miller; Amanda R Ricchio; Julia A Schweiger; Robert L Findling; Denise Wilfley; John W Newcomer Journal: J Child Adolesc Psychopharmacol Date: 2019-04-17 Impact factor: 2.576
Authors: Nancy L Zucker; Philip A Kragel; Henry Ryan Wagner; Lori Keeling; Emeran Mayer; Joyce Wang; Min Su Kang; Rhonda Merwin; W Kyle Simmons; Kevin S LaBar Journal: Psychosom Med Date: 2017 Nov/Dec Impact factor: 4.312
Authors: Claire Trainor; Sasha Gorrell; Elizabeth K Hughes; Susan M Sawyer; Claire Burton; Daniel Le Grange Journal: Eur Eat Disord Rev Date: 2020-01-29
Authors: Erin C Accurso; Ellen Astrachan-Fletcher; Setareh O'Brien; Susan F McClanahan; Daniel Le Grange Journal: Eat Disord Date: 2017-06-01 Impact factor: 3.222
Authors: Gina Dimitropoulos; Ashley L Landers; Victoria Freeman; Jason Novick; Andrea Garber; Daniel Le Grange Journal: J Can Acad Child Adolesc Psychiatry Date: 2018-01-01