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Table 9 Multi family therapy for eating disorders

From: Canadian practice guidelines for the treatment of children and adolescents with eating disorders

Certainty assessment

Impact

Certainty

Importance

DE

Study design

Risk of bias

Inconsistency

Indirectness

Imprecision

Other considerations

Good Outcome at End of Treatment (assessed with: Morgan Russell Scale), Psychological Symptoms (EDE)

 1

randomised trials

not serious

not serious

not serious

not serious

none

RCT (n = 169) of adolescents with AN aged 11–18 comparing MFT to FBT (91% female). 65/86 (75.6%) good outcome at end of treatment in MFT versus 48/83 (57.8%) in the FBT group - significant difference.

No differences between groups seen on the EDE. Both groups improved over time on the EDE.

HIGH

CRITICAL

not serious

not serious

not serious

not serious

none

No differences between groups seen on the EDE. Both groups improved over time on the EDE.

HIGH

CRITICAL

Weight (assessed with: Percent ideal body weight)

 1

Case control

serious a

not serious

not serious

not serious

none

Retrospective case control study looking at MFT versus TAU for AN. 50 female adolescents aged 11–18 were included (25 in MFT group and 25 in TAU group). Those in MFT restored weight to a higher percentage (99.6% vs. 95.4%).

VERY LOW

CRITICAL

Weight (assessed with: kg and BMI) Psychological Symptoms (assessed with: EDE, EDI)

 4

Case Series

very serious a,b

not serious

not serious

not serious

none

Four studies without a control condition. Total n = 142 adolescents (5 males, 137 females), Diagnoses were mixed including AN, EDNOS and BN. Significant improvements in weight were reported.

VERY LOW

CRITICAL

very serious a,b

not serious

not serious

not serious

none

Improvements in psychological symptoms were seen pre to post MFT.

In a case series of 10 adolescents aged 13 to 18 years, EDE scores decreased from 4.31 to 3.41 (cohen’s d 0.82).

VERY LOW

CRITICAL

  1. ano randomization
  2. bno control condition
  3. Bibliography:
  4. RCT – Eisler 2016 [76]
  5. Case control - Gabel 2014 [77]
  6. Case Series - Gelin 2015 [80], Hollesen 2013 [78], Salaminiou 2017 [79], Stewart 2015 [81]