A systematic review and meta-analysis of intensive treatment options for adults with eating disorders

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL Clinical Psychology Review Pub Date : 2023-10-26 DOI:10.1016/j.cpr.2023.102354

Kathleen de Boer , Catherine Johnson , Tracey D. Wade , Marcela Radunz , Anne Nileshni Fernando , Jennifer Babb , Simon Stafrace , Gemma Sharp

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Abstract

Eating disorders (EDs) are complex conditions with one of the highest mortality rates among psychiatric illnesses. While outpatient evidence-based treatments for EDs in adults exist, there is often utilisation of more intensive interventions as part of treatment. However, a comprehensive analysis of the impacts of intensive treatment (inpatient, residential and day program) on physical and psychosocial outcomes is lacking. Thus, the current systematic review and meta-analysis aimed to investigate the effectiveness of intensive treatments in adults with EDs for the outcomes of body mass index (BMI), disordered eating, depression, and quality of life, as well as a moderation analysis investigating a range of clinical characteristics. Overall, 62 studies were included in the meta-analysis. The results revealed that intensive treatment in adults yielded significant improvements in BMI (for underweight patients), disordered eating, depression, and quality of life. Treatment setting, length of stay and geographical region of the study all served as moderators for disordered eating and depression. Nevertheless, given the high heterogeneity in the meta- and moderation analyses, these results should be interpreted with caution. Future high-quality research is needed to determine the most beneficial elements of intensive treatment (compared to outpatient) in adults with EDs.

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对成人饮食失调强化治疗方案的系统回顾和荟萃分析

饮食失调是一种复杂的疾病，是精神疾病中死亡率最高的疾病之一。虽然存在针对成人急症的门诊循证治疗，但通常使用更密集的干预措施作为治疗的一部分。然而，对强化治疗(住院、住院和日间治疗)对身体和心理结果的影响的综合分析是缺乏的。因此，当前的系统回顾和荟萃分析旨在调查强化治疗对成人ed患者体重指数(BMI)、饮食失调、抑郁和生活质量的影响，以及调查一系列临床特征的适度分析。总的来说，荟萃分析纳入了62项研究。结果显示，成人强化治疗显著改善了BMI(体重过轻患者)、饮食失调、抑郁和生活质量。治疗环境、停留时间和研究的地理区域都是饮食失调和抑郁的调节因子。然而，考虑到meta分析和适度分析的高度异质性，这些结果应该谨慎解释。未来需要高质量的研究来确定强化治疗(与门诊相比)对成人急症患者最有益的因素。

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来源期刊

Clinical Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

23.10

自引率

1.60%

发文量

期刊介绍： Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.