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Title: Family therapy for anorexia nervosa.
Austin Authors: Fisher, Caroline A;Hetrick, Sarah E;Rushford, Nola
Affiliation: Department of Clinical Neuropsychology, Austin Health, Heidelberg Repatriation Hospital, and Centre of Excellence in Youth Mental Health, Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, PO Box 5444, Heidelberg West, Victoria, Australia, 3081.
Issue Date: 14-Apr-2010
Publication information: The Cochrane Database of Systematic Reviews 2010; (4): CD004780
Abstract: Anorexia Nervosa (AN) is characterised by distorted body image and deliberately maintained low body weight. The long term prognosis is often poor, with severe medical, developmental and psychosocial complications, high rates of relapse and mortality. Different variants of family therapy have been commonly used for intervention.To evaluate the efficacy of family therapy compared with standard treatment and other treatments.The Cochrane Collaboration Depression, Anxiety and Neuroses Controlled Trials Register (CCDANCTR) was searched until August 2008; MEDLINE, PsycInfo and EMBASE and were searched up to January 2008. A conference abstract book and included studies reference lists were searched. All lead authors of included studies were also contacted.Randomised controlled trials (RCTS) of interventions described as 'family therapy' compared to any other intervention or other types of family therapy were eligible for inclusion. Patients of any age or gender with a primary clinical diagnosis of anorexia nervosa (AN) were included.Two review authors selected the studies, assessed quality and extracted data. We used a random effects meta-analysis. Relative risk was used to summarise dichotomous outcomes and both the standardised mean difference and mean difference to summarise continuous measures.13 trials were included, the majority investigating family based therapy, or variants. Reporting of trial conduct was generally inadequate. The full extent of the risk of bias is unclear. There was some evidence (from two studies, 81 participants) to suggest that family therapy may be more effective than treatment as usual on rates of remission, in the short term (RR 3.83 95% CI 1.60 to 9.13). Based on one study (30 participants) there was no significant advantage for family therapy over educational interventions (RR 9.00 95% CI 0.53, 153.79) or over other psychological interventions (RR 1.13 95% CI 0.72 to 1.76) based on four studies (N=149).All other reported comparisons for relapse rates, cognitive distortion, weight measures and dropouts yielded non-significant results.There is some evidence to suggest that family therapy may be effective compared to treatment as usual in the short term. However, this is based on few trials that included only a small number of participants, all of which had issues regarding potential bias. There appears to be little advantage of family therapy over other psychological interventions. The field would benefit from a large, well-conducted trial.
Gov't Doc #: 20393940
DOI: 10.1002/14651858.CD004780.pub2
Type: Journal Article
Subjects: Anorexia Nervosa.therapy
Family Therapy.methods
Randomized Controlled Trials as Topic
Treatment Outcome
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