Family Therapy and Fluoxetine in the Treatment of Adolescents

家庭治疗和氟西汀治疗青少年

• 批准号: 7033611
• 负责人: WALTER H KAYE
• 金额: $ 18.56万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-19 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7033611
• 关键词: adolescence (12-20); anorexia nervosa; anxiety; behavioral /social science research tag; body weight; child behavior disorders; clinical research; clinical trials; combination therapy; compulsive behavior; cooperative study; developmental nutrition; eating disorders; family therapy; fluoxetine; human subject; human therapy evaluation; interview; longitudinal human study; outpatient care; patient oriented research; sign /symptom

DESCRIPTION (provided by applicant): The long-term objective of this proposal is to enhance the treatment and outcome of anorexia nervosa (AN) and to develop a network of research and training centers to support innovative research in AN. Research on the treatment of AN has lagged that of other conditions, even other eating disorders such as bulimia nervosa, hence it is important to test potentially effective treatments in a large scale study so as to provide a baseline for future studies. The focus of this proposal is on adolescent AN. Successful early treatment is likely to reduce the prevalence of chronic AN with its high rates of morbidity and mortality and high health care costs. The most promising treatment for adolescent AN is a specific form of family therapy, (the Maudsley approach) called here, behavioral family therapy (BFT). This treatment is focused on the disordered eating behavior that characterizes AN and enables parents to refeed their child. Additionally, there is preliminary evidence that fluoxetine may be useful in reducing comorbid psychopathology and enhancing maintenance in AN. However, there has been no placebo controlled study of fluoxetine in adolescent AN. Moreover, although there have been several small-scale studies of BFT there has been no controlled comparison with another form of family therapy. Hence, we propose to use systems family therapy (SFT) which has been developed and manualized to represent the type of family therapy practiced in the community. We propose to randomly allocate 240 adolescents aged 12-18 years with AN and their families to one of 4 groups: BFT + placebo; BFT + fluoxetine; SFT + placebo; and SFT + fluoxetine. Medication will be continued for 6-months beyond the end of family therapy to assess medication effects on the maintenance of therapeutic gains. Treatment and assessment will be carried out at 6 clinical sites with 40 subjects per site with separate data and coordinating centers. The treatment sites will follow common assessment and treatment protocols with detailed monitoring of recruitment, treatment, assessment and human subjects procedures by the coordinating center. The results of this study should provide guidance to clinicians concerning optimal treatment approaches for adolescent AN. From the public health perspective, development of effective treatments for adolescents will reduce the morbidity, mortality, and high costs associated with chronic AN.

描述（由申请人提供）：该提案的长期目标是增强神经性厌食症（AN）的治疗和结果，并建立一个研究和培训中心网络，以支持AN中的创新研究。关于AN治疗的研究落后于其他疾病，即使是其他饮食失调症，例如神经性贪食症，因此在大规模研究中测试潜在有效治疗非常重要，以便为将来的研究提供基准。该提议的重点是青少年。成功的早期治疗可能会降低其发病率和高死亡率和高医疗保健成本的慢性A的患病率。青少年和最有前途的治疗方法是一种特定的家庭疗法，即（Maudsley方法），称之为行为家庭疗法（BFT）。这种疗法的重点是特征在于AN并使父母能够养育孩子的饮食行为。此外，有初步证据表明，氟西汀可能有助于减少合并症的心理病理学和增强AN的维持。但是，在青少年中没有安慰剂对照研究。此外，尽管已经进行了几项小规模研究，但与另一种形式的家庭疗法没有控制的比较。因此，我们建议使用已开发和手动的系统家庭疗法（SFT），以代表社区实践的家庭疗法类型。我们建议将240名12-18岁的青少年与AN及其家人分配给4组之一：BFT +安慰剂； BFT +氟西汀； SFT +安慰剂;和SFT +氟西汀。在家庭疗法结束之外，将继续服药6个月，以评估药物对维持治疗增长的影响。将在6个临床部位进行治疗和评估，每个部位有40个受试者，并具有单独的数据和协调中心。治疗部位将遵循共同的评估和治疗方案，并通过协调中心详细监测招募，治疗，评估和人类受试者程序。这项研究的结果应为临床医生提供有关青少年AN的最佳治疗方法的指导。从公共卫生的角度来看，为青少年开发有效的治疗方法将降低与慢性AN相关的发病率，死亡率和高成本。