Eliza D. Newton, Liquan Liu, J. Conti, Stephen Touyz, Jon Arcelus, S. Madden, Kathleen Pike, Phillipa Hay
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Polynomial regression was utilised to examine the effects of varying combinations of baseline and 10-week self-reported physical-health-relatedr QoL (SF-12; PHRQoL subscale), mental-health-related QoL (SF-12; MHRQoL subscale), and eating-disorder-specific QoL (EDQoL; global, psychological, cognitive/physical, financial, and school/work subscales) on end-of-treatment BMI, ED psychopathology, and QoL. Greater magnitudes of early change in global EDQoL scores, both positive and negative, predicted better MHRQoL but not BMI or ED psychopathology at the end of treatment. Psychological EDQoL ratings also accounted for 38.1% of the variance in end-of-treatment ED psychopathology, although tests examining the 6ratings may be meaningful in predicting treatment outcomes. The positive impact of early worsening in QoL ratings suggests that early QoL ratings are inflated due to denial and poor insight. 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引用次数: 0
摘要
本研究旨在探讨自我报告的生活质量(QoL)的早期变化是否能预测神经性厌食症(AN)的治疗效果。鉴于有人认为厌食症患者在不舒服时会高估自己的生活质量,我们假设,自我报告的生活质量的任何早期变化,无论是早期改善还是早期恶化,都将预测治疗结束时体重指数(BMI)、进食障碍(ED)心理病理学和生活质量的更好结果。78 名成年门诊患者接受了神经性厌食症认知行为疗法(CBT-AN)治疗,其中包括或不包括强迫性运动模块 "强迫性运动活动疗法"(LEAP)。我们利用多项式回归法研究了基线和 10 周自我报告的身体健康相关 QoL(SF-12;PHRQoL 子量表)、心理健康相关 QoL(SF-12;MHRQoL 子量表)和进食障碍特定 QoL(EDQoL;整体、心理、认知/身体、经济和学校/工作子量表)的不同组合对治疗结束时体重指数、进食障碍心理病理学和 QoL 的影响。总体 EDQoL 评分的早期变化幅度越大(包括积极和消极的变化),则预示着治疗结束时 MHRQoL 的改善,而不是 BMI 或 ED 精神病理学的改善。心理 EDQoL 评分也占治疗结束时 ED 精神病理学变异的 38.1%,尽管对 6 项评分的检测可能对预测治疗结果有意义。早期 QoL 评分恶化的积极影响表明,由于否认和洞察力差,早期 QoL 评分被夸大了。临床医生应该放心,早期 QoL 下降并不表示治疗失败。
Early Change in Quality of Life in the Treatment of Anorexia Nervosa
This study aimed to examine whether early change in self-reported quality of life (QoL) was a predictor of outcomes in the treatment of anorexia nervosa (AN). Given suggestions that people with AN overestimate their QoL when unwell, we hypothesised that any early change in self-reported QoL, be it an early improvement or early worsening, would predict better outcomes in terms of end-of-treatment body mass index (BMI), eating disorder (ED) psychopathology, and QoL. Participants were 78 adult outpatients engaged in cognitive behaviour therapy for anorexia nervosa (CBT-AN) either with or without the embedded compulsive exercise module “compuLsive Exercise Activity TheraPy” (LEAP). Polynomial regression was utilised to examine the effects of varying combinations of baseline and 10-week self-reported physical-health-relatedr QoL (SF-12; PHRQoL subscale), mental-health-related QoL (SF-12; MHRQoL subscale), and eating-disorder-specific QoL (EDQoL; global, psychological, cognitive/physical, financial, and school/work subscales) on end-of-treatment BMI, ED psychopathology, and QoL. Greater magnitudes of early change in global EDQoL scores, both positive and negative, predicted better MHRQoL but not BMI or ED psychopathology at the end of treatment. Psychological EDQoL ratings also accounted for 38.1% of the variance in end-of-treatment ED psychopathology, although tests examining the 6ratings may be meaningful in predicting treatment outcomes. The positive impact of early worsening in QoL ratings suggests that early QoL ratings are inflated due to denial and poor insight. Clinicians should be reassured that early QoL decline does not indicate treatment failure.