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Treatment of eating disorders: A systematic meta-review of meta-analyses and network meta-analyses

Forfatter(e)
Monteleone, A. M. Pellegrino, F. Croatto, G. Carfagno, M. Hilbert, A. Treasure, J. Wade, T. Bulik, C. M. Zipfel, S. Hay, P. Schmidt, U. Castellini, G. Favaro, A. Fernandez-Aranda, F. Il Shin, J. Voderholzer, U. Ricca, V. Moretti, D. Busatta, D. Abbate-Daga, G. Ciullini, F. Cascino, G. Monaco, F. Correll, C. U. Solmi, M.
År
2022
DOI
10.1016/j.neubiorev.2022.104857
Tidsskrift
Neuroscience & Biobehavioral Reviews
Sider
104857
Kategori(er)
Spiseforstyrrelser
Tiltakstype(r)
FamilieterapiForeldreveiledning/-terapiAntidepressivaSentralstimulerende medikamenter Fysisk aktivitet Selvhjelp
Abstract

Treatment efficacy for eating disorders (EDs) is modest and guidelines differ. We summarized findings/quality of (network) meta-analyses (N)MA of randomized controlled trials (RCTs) in EDs. Systematic meta-review ((N)MA of RCTs, ED, active/inactive control), using (anorexia or bulimia or eating disorder) AND (meta-analy*) in PubMed/PsycINFO/Cochrane database up to December 15th, 2020. Standardized mean difference, odds/risk ratio vs control were summarized at end of treatment and follow-up. Interventions involving family (family-based therapy, FBT) outperformed active control in adults/adolescents with anorexia nervosa (AN), and in adolescents with bulimia nervosa (BN). In adults with BN, individual cognitive behavioural therapy (CBT)-ED had the broadest efficacy versus active control; also, antidepressants outperformed active. In mixed age groups with binge-eating disorder (BED), psychotherapy, and lisdexamfetamine outperformed active control. Antidepressants, stimulants outperformed placebo, despite lower acceptability, as did CBT-ED versus waitlist/no treatment. Family-based therapy is effective in AN and BN (adolescents). CBT-ED has the largest efficacy in BN (adults), followed by antidepressants, as well as psychotherapy in BED (mixed). Medications have short-term efficacy in BED (adults).