Disorders - Anorexia Nervosa
Bachar, Eytan, Latzer, Yael, Kreitler, Shulamit, Berry, Elliot M.
The authors investigated the applicability of self psychological treatment (SPT) and cognitive orientation treatment (COT) to the treatment of anorexia and bulimia. 33 female patients (mean age 24 yrs) participated in this study. The bulimic patients (N=25) were randomly assigned either to SPT, COT, or control/nutritional counseling only (C/NC). The anorexic patients (N=8) were randomly assigned to either SPT or COT. Patients were administered a battery of outcome measures assessing eating disorders symptomatology, attitudes toward food, self structure, and general psychiatric symptoms. After SPT, significant improvement was observed. After COT, slight but nonsignificant improvement was observed. After C/NC, almost no changes could be detected. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Psychotherapy Practice & Research, 8(2) : 115-128
- Year: 1999
- Problem: Anorexia Nervosa, Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Robin, Arthur L., Siegel, Patricia T., Moye, Ann W., Gilroy, Marcia, Dennis, Amy Baker, Sikand, Anju
Compared the effectiveness of behavioral family systems therapy (BFST) with that of ego-oriented individual therapy (EOIT) as treatments for adolescents with anorexia nervosa. 37 females (aged 11-20 yrs) with anorexia nervosa were randomly assigned to receive BFST or EOIT, in addition to a common medical and dietary regimen. In BFST, the family was seen conjointly, the parents were placed in control of the adolescent's eating, distorted beliefs were targeted through cognitive restructuring, and strategic/behavioral interventions were used to change family interactions. In EOIT, the adolescent was seen individually, with an emphasis on building ego strength and uncovering the dynamics blocking eating; parents were seen collaterally. Measures administered before, after, and at 1-yr follow-up tapped body mass index, menstruation, eating attitudes, ego functioning, depression, and family interactions. BFST produced greater weight gain and higher rates of resumption of menstruation than EOIT. Both treatments produced comparably large improvements in eating attitudes, depression, and eating-related family conflict, but very few changes occurred on ego functioning. BFST and EOIT proved to be effective treatments, but BFST produced a faster return to health. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Journal of the American Academy of Child & Adolescent Psychiatry, 38(12) : 1482-1489
- Year: 1999
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy, Other Psychological Interventions
Serfaty, Marc A., Turkington, Douglas, Heap, Michael, Ledsham, Lynne, Jolley, Elizabeth
Cognitive therapy has been used in anorexia nervosa, but little is known about its effectiveness. A randomized controlled trial was undertaken comparing dietary advice with cognitive therapy in the outpatient treatment of anorexia nervosa. Thirty-five patients were randomly allocated to either cognitive therapy (n=25) or dietary advice (n=10). There were no significant differences in the groups pre-treatment. Twenty sessions of cognitive therapy or dietary advice were offered. Results showed that at 6 mo, 23 cognitive therapy patients remained engaged whereas all the dietary advice controls dropped out. Cognitive therapy patients showed significant changes in Body Mass Index (p=0.001), Eating Disorder Inventory Scores (p=0.035), Beck Depression Inventory Scores (p<0.0001) and Locus of Control of Behaviour Scores (p=0.017). It is concluded that significant improvements were observed in patients allocated to cognitive therapy, but not in those allocated to dietary advice on an intention to treat analysis. Cognitive therapy has advantages of promoting engagement and facilitating recovery. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
European Eating Disorders Review, 7(5) : 334-350
- Year: 1999
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Dietary advice, dietary change
Attia, E., Haiman, C., Timothy Walsh, B., Flater, S. R.
Objective: While pharmacological interventions are of established utility in bulimia nervosa, medications have no clear role in the treatment of anorexia nervosa. Because patients with anorexia nervosa frequently exhibit mood disturbances and symptoms of obsessive-compulsive disorder, the authors tested the utility of fluoxetine in the treatment of women participating in an inpatient program for anorexia nervosa. Method: The authors conducted a randomized, placebo-controlled, double-blind, 7-week study of fluoxetine at a target daily dose of 60 mg in 31 women with anorexia nervosa receiving treatment for their eating disorder on a clinical research unit. Body weight and measures of eating behavior and psychological state were obtained at baseline and at termination. Results: There were no significant differences in clinical outcome on any measure between patients receiving fluoxetine and patients receiving placebo. Conclusions: Fluoxetine does not appear to add significant benefit to the inpatient treatment of anorexia nervosa.
American Journal of Psychiatry., 155(4) : 548-551
- Year: 1998
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs)
Andrewes, David G., O'Connor, Peter, Mulder, Claudia, McLennan, Jim, et al.,
Assessed a new computer-based method of health education for patients with bulimia and anorexia nervosa. 54 patients with eating disorders were allocated randomly to 1 of 2 groups to receive either a computer-presented health education package (DIET) or a placebo computer-based program. Both groups were assessed before and after intervention on a questionnaire measuring knowledge of eating disorders and a questionnaire measuring attitudes to eating-disordered behavior. The DIET group members were significantly improved when compared to the placebo group in terms of both their knowledge and attitudes towards their disorder. The patients rated the DIET program as being both easy to use and helpful. Thus, the DIET program has been found to be a resource-efficient means of health education for patients with eating disorders. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Australian & New Zealand Journal of Psychiatry, 30(4) : 492-497
- Year: 1996
- Problem: Anorexia Nervosa, Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Technology, interventions delivered using technology (e.g. online, SMS)
Treasure, J., Todd, G., Brolly, M., Tiller, J., Nehmed, A., Denman, F.
The aim of this study was to compare two forms of outpatient treatment, educational behavioural treatment and cognitive analytical therapy for adult anorexia nervosa. Thirty patients were randomly allocated to the two treatments. At one year, the group had gained 6.8 kg, 19/30 (63%) had a good or intermediate recovery in terms of nutritional outcome. The group given cognitive analytical treatment reported significantly greater subjective improvement but there were no differences in other outcome parameters. In conclusion outpatient treatment of adult onset anorexia nervosa leads to an improvement in two thirds of cases. Larger studies will be needed to determine the most effective form of treatment in this group.
Behaviour Research & Therapy, 33(4) : 363-7
- Year: 1995
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Cognitive analytic therapy (CAT)
Robin, A. L., Siegel, P. T., Koepke, T., Moye, A. W., Tice, S.
Behavioral family systems therapy (BFST) was compared with ego-oriented individual therapy (EOIT) in a controlled, random-assignment investigation involving 22 young adolescents with anorexia nervosa. Each adolescent and her parents received approximately 16 months of outpatient therapy along with a common medical and dietary regimen. BFST emphasized parental control over eating and weight gain, coupled with cognitive restructuring and problem-solving communication training. EOIT emphasized building ego strength, adolescent autonomy, and insight into the emotional blocks to eating. BFST produced greater change on body-mass index than did EOIT, but both treatments produced comparable improvements on eating attitudes, body shape dissatisfaction, interoceptive awareness, depression/internalizing psychopathology, and eating-related family conflict. The implications of these results for the clinician who treats adolescents with anorexia nervosa are discussed.
Journal of Developmental & Behavioral Pediatrics, 15(2) : 111-6
- Year: 1994
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy, Other Psychological Interventions
Gowers, Simon, Norton, Kingsley, Halek, Christine, Crisp, Arthur H.
Randomly allocated 90 adolescent and young women with anorexia nervosa to 4 treatment options: 1 inpatient, 2 outpatient, and 1 comprising an assessment interview only. 20 Ss were thus offered a package of outpatient individual and family psychotherapy. At 2-yr follow-up, 12 of the 20 were classed as well, or very nearly well, according to operationally defined criteria. Statistically significant improvements over time were obtained for weight, mean body mass index (BMI), and also for psychological, sexual, and socioeconomic adjustments. Weight and BMI changes were significantly better than for the assessment only group, some of whom had received extensive treatment elsewhere. The style of the outpatient therapy and compliance with it are described, and prognostic indicators for the treated and untreated groups are presented. Lower weights at presentation and vomiting were associated with poorer outcome. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
International Journal of Eating Disorders, 15(2) : 165-177
- Year: 1994
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement interventions
leGrange, D., Eisler, I., Dare, C., Russell, G. F. M.
In the search for more effective methods of psychological treatment in anorexia nervosa, there are a number of controlled trials evaluating the efficacy of different forms of treatment. Previous studies have shown that family therapy is the superior treatment for patients with an early onset and short duration of illness. In order to assess the impact and the effective components of family therapy, we conducted a pilot trial in which consecutive referrals of anorexia nervosa patients were randomly assigned to one of two forms of family treatment: family therapy (conjoint family sessions) or family counselling (separate supportive sessions for the patient and counselling for the parents). Changes taking place within the patient and the family were evaluated at regular intervals, while within and between group comparisons were made. Although tentative, it was found that, in the short term, there were few differences in terms of symptomatic relief between the two treatment groups.
International Journal of Eating Disorders., 12(4) : 347-357
- Year: 1992
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy
Crisp, A., Norton, Kingsley, Gowers, Simon, Halek, Christine, et al.,
90 female patients with severe anorexia nervosa fulfilling Diagnostic and Statistical Manual of Mental Disorders-III--Revised (DSM-III--R) criteria were assessed in depth in terms of their family developmental psychopathology and then randomly allocated to 1 of 3 treatment groups or to no treatment. In the treatment regimes, a behavioral approach to diet and weight gain was coupled with individual and family psychotherapy directed at the adolescent maturational problems. All 3 treatment regimes were highly significantly effective at 1 yr in terms of weight gain, return of menstruation, and aspects of social and sexual adjustment. Body weights above those at pubertal onset were achieved for the group mean maximum and 1-yr follow-up weights for all 3 treatment groups but not for the control group. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
British Journal of Psychiatry, 159(Sep) : 325-333
- Year: 1991
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Family therapy, Other Psychological Interventions, Dietary advice, dietary change
Channon, Shelley, de Silva, Padmal, Hemsley, David, Perkins, Rachel E.
Investigated whether a cognitive-behavioral treatment (CBT) procedure was superior to a standard behavioral treatment (SBT) in 24 outpatients with anorexia nervosa. Ss were assigned to 1 of 3 treatment groups: 8 (mean age 21.6 yrs) in the CBT, 8 (mean age 24.1 yrs) in the SBT, and 8 (mean age 25.7 yrs) in a control treatment. Changes in weight and clinical features (e.g., menstrual status) formed the basis of the outcome measures. Ss completed measures, including the Beck Depression Inventory, an obsessional-compulsive inventory, and self-reports of symptoms of eating disorders, and preferred weight. Ss showed significant improvement. CBT and SBT Ss showed significant differences on only a few of the outcome measures; however, CBT Ss attended more treatment sessions, suggesting that this treatment was more acceptable than the SBT. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Behaviour Research & Therapy, 27(5) : 529-535
- Year: 1989
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Hall, A., Crisp, A. H.
Thirty out-patients with severe anorexia nervosa were randomly allocated to either 12 sessions of dietary advice or 12 sessions of combined individual and family psychotherapy. At one-year follow-up both groups showed significant overall improvement, and the dietary advice group showed significant weight gain. A similar mean weight gain for the psychotherapy patients did not reach statistical significance, but this group made significant improvements in sexual and social adjustment.
British Journal of Psychiatry, 151 : 185-91
- Year: 1987
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Family therapy, Dietary advice, dietary change