Objective Anorexia nervosa is a disorder of high morbidity and significant mortality. The aim of the present review was to evaluate the evidence from randomized controlled trials for the efficacy of outpatient psychotherapies used in the treatment of older adolescents ( aged ＞16 years) and adults with anorexia nervosa. Methods The search strat egy comprised database searches of Medline, EXTRAMED, EMBASE, PSYCLIT, Current Contents, Cochrane Con trolled Trials Register and the Depression and Anxiety Neurosis Cochrane Group ( CCDAN), the search date was Novem ber 2002. A hand-search of The International Journal of Eating Disorders from its first issue up to March 2003, and the ref erence lists of all papers selected. Personal letters were sent to identified leading researchers published in the area, requesting information on trials that are unpublished. All randomized controlled trials of adult individual outpatient therapy for anorexia nervosa, as defined by the DSM-IV or similar international criterion, were included. Quality ratings were made according to the CCDAN criteria. A range of outcome variables were selected, including physical state, severity of eating disorder attitudes and behefs, interpersonal function, and general psychiatric symptom severity. Continuous outcome data comparisons were planned with the standardized mean difference statistic, and binary outcome comparisons planned with the relative risk statistic. Results Six small trials only, two of which included children or adolescents, were identified from the search and aggregation of data was not possible. Bias was possible due to lack of blinding of outcome assessments. The results in two trials suggested that "treatment as usual" or similar may be less efficacious than a specific psychotherapy. No specific treatment was consistently superior to any other specific approach. Dietary advice as a control arm had a 100% non-completion rate in one trial. Conclusions No specific approach can be recommended from this review. It is unclear why "treatment as usual" performed so poorly, or why dietary advice alone appeared so unacceptable. There is an urgent need for large well-designed trials in this area.
Objective To explore the characteristics of parenting styles of female patients with anorexia nervosa (AN) and bulimia nervosa (BN), to and provide a reference for the clinical treatment of eating disorders. Methods Patients with AN and BN between November 2019 and May 2020 in the Centre for Mental Health, West China Hospital, Sichuan University were retrospectively included. Female teachers and students from Sichuan University were used as normal controls. The general conditions of the subjects in the three groups were collected, and the parenting styles and behaviors of the subjects in the three groups were evaluated using Egna Minnen av Barndoms Uppfostran (Parenting Style Evaluation Scale). Results Finally, 30 subjects were included in the AN group, 44 subjects were included in the BN group, and 33 subjects were included in the healthy control group. There was no significant difference in the course of disease between the AN group and the BN group (P>0.05). There were no significant differences in age, place of residence, education level, parental divorce, parental education level and parental occupation among the three groups (P>0.05). The body mass index of the AN group was lower than that of the BN group and the healthy control group (P<0.05). The parenting style evaluation scale scores showed that in terms of father scores, there was no significant difference in the excessive interference dimension scores among the three groups (P>0.05). The score of preference dimension in AN group (14.60±4.45 vs. 10.18±5.98 vs. 10.36±5.90) was higher than that in BN group and healthy control group, the score of emotional warmth and understanding dimension in BN group (50.55±11.81 vs. 55.33±9.12 vs. 57.03±6.13) was lower than that in the AN group and the healthy control group, and the scores of rejection and denial dimension (7.91±3.65 vs. 10.10±3.85 vs. 10.16±3.83) and overprotection dimension (11.76±2.82 vs. 14.10±3.16 vs. 13.25±2.97) in healthy control group were lower than those of AN group and BN group (P<0.05). In terms of mother scores, the scores of preference dimension (14.40±4.64 vs. 10.59±5.92 vs. 10.94±5.34) in AN group was higher than that in the BN group and the healthy control group, and the scores of emotional warmth and understanding dimension (58.06±7.05 vs. 51.40±11.79 vs. 52.91±11.57) in healthy control group was higher than that in AN group and BN group (P<0.05). Conclusion Compared with healthy controls, the parenting styles of female patients with eating disorders show more negative emotions such as rejection and denial. The parenting styles of female BN patients show more negative emotions than female AN patients. These all suggest that the parenting style, attitude and behavior may be the influencing factors of female AN and BN.