title: Randomized Clinical Trial of Parent-Focused Treatment and Family-Based Treatment for Adolescent Anorexia Nervosa.
abstract: There have been few randomized clinical trials (RCTs) for adolescents with anorexia nervosa (AN). Most of these posit that involving all family members in treatment supports favorable outcomes. However, at least 2 RCTs suggest that separate parent and adolescent sessions may be just as effective as conjoint treatment. This study compared the relative efficacy of family-based treatment (FBT) and parent-focused treatment (PFT). In PFT, the therapist meets with the parents only, while a nurse monitors the patient.
  
  
  
  Participants (N = 107) aged 12 to 18 years and meeting DSM 4(th)Edition criteria for AN or partial AN were randomized to either FBT or PFT. Participants were assessed at baseline, end of treatment (EOT), and at 6 and 12 months posttreatment. Treatments comprised 18 outpatient sessions over 6 months. The primary outcome was remission, defined as ≥95% of median body mass index and Eating Disorder Examination Global Score within 1 SD of community norms.
  
  
  
  Remission was higher in PFT than in FBT at EOT (43% versus 22%; p = .016, odds ratio [OR] = 3.03, 95% CI = 1.23-7.46), but did not differ statistically at 6-month (PFT 39% versus FBT 22%; p = .053, OR = 2.48, CI = 0.989-6.22), or 12-month (PFT 37% versus FBT 29%; p = .444, OR = 1.39, 95% CI = 0.60-3.21) follow-up. Several treatment effect moderators of primary outcome were identified.
  
  
  
  At EOT, PFT was more efficacious than FBT in bringing about remission in adolescents with AN. However, differences in remission rates between PFT and FBT at follow-up were not statistically significant.
  
  
  
  A Randomised Controlled Trial of Two Forms of Family-Based Treatment and the Effect on Percent Ideal Body Weight and Eating Disorders Symptoms in Adolescent Anorexia Nervosa; http://www.anzctr.org.au/; ACTRN12610000216011.
authors.affiliation: University of Melbourne, Australia; University of California, San Francisco; and The University of Chicago, IL (emeritus). Electronic address: daniel.legrange@ucsf.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Le Grange
authors.affiliation: University of Melbourne and Murdoch Childrens Research Institute, Australia.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Hughes
authors.affiliation: Centre for Adolescent Health, Royal Children's Hospital.
authors.forename: Andrew
authors.initials: A
authors.lastname: Court
authors.affiliation: Centre for Adolescent Health, Royal Children's Hospital.
authors.forename: Michele
authors.initials: M
authors.lastname: Yeo
authors.affiliation: Neuropsychiatric Research Institute, Fargo, ND, and University of North Dakota School of Medicine and Health Sciences, Fargo.
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
authors.affiliation: University of Melbourne, Centre for Adolescent Health, Royal Children's Hospital, and Murdoch Childrens Research Institute, Melbourne.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sawyer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000856:Anorexia Nervosa / Q000628:therapy*; D002648:Child; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000523:psychology*
keywords: adolescents; anorexia nervosa; family-based treatment; parent-focused treatment; treatment outcome