Table 6 FBT adjuncts for children and adolescents with anorexia nervosa
From: Canadian practice guidelines for the treatment of children and adolescents with eating disorders
Certainty assessment | Impact | Certainty | Importance | ||||||
|---|---|---|---|---|---|---|---|---|---|
№ of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | |||
Psychological symptoms (EDE) | |||||||||
1 | randomised trials Art therapy vs. CRT | not serious | not serious | not serious | not serious | none | RCT examining FBT plus either Art Therapy or Cognitive Remediation Therapy. Global EDE score was slightly more improved in the Art Therapy Group (p < 0.03, n = 30). | ⨁⨁⨁⨁ HIGH | CRITICAL |
Weight Restoration (assessed with: Median BMI) | |||||||||
1 | Case control FBT +/−skills workshop | serious a | not serious | not serious | not serious | none | One case control study described 45 families who had FBT with 45 families who had FBT plus a parent education and skills workshop. Week 4 weight gain was higher in those with the workshop, but there were no significant differences at the end of the study. | ⨁◯◯◯ VERY LOW | CRITICAL |
Weight (assessed with: pounds and %expected body weight) | |||||||||
1 | Case series DBT added | very serious a,b | not serious | not serious | not serious | none | One case series (n = 11) of DBT added to FBT in a community-based clinic. 2/11 achieved full weight restoration at end of treatment | ⨁◯◯◯ VERY LOW | CRITICAL |
very serious a,b | not serious | not serious | not serious | none | 6/11 had normal EDE scores at the end of the study. | ⨁◯◯◯ VERY LOW | CRITICAL | ||
Weight | |||||||||
2 | Case reports Emotion coaching | very serious a,b | not serious | not serious | not serious | none | Two case reports of two patients with AN (one male) treated with adjunctive emotion coaching and the other with Attachment Based Family Therapy during a course of FBT. Both improved in weight to be fully weight restored. | ⨁◯◯◯ VERY LOW | CRITICAL |