Disorders - Anorexia Nervosa
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
Russell, Gerald F., Szmukler, George I., Dare, Christopher, Eisler, I.
Evaluated the use of family therapy (FT) in treating 57 anorexic and 23 bulimic outpatients (mean age
21.8 yrs). Ss were randomly assigned to FT or individual supportive therapy (IST) and a follow-up was conducted at 1 yr. Results indicate that FT was
more effective than IST in nonchronic patients who began treatment before age 19 yrs. In older patients, IST led to more weight gain than FT, but
this improvement fell short of recovery in most Ss. Duration of hospital stay, use of antidepressant medication, differences in FT frequency, and
dropout rates are examined as sources of bias. The effects of FT on members of the family other than the patient are discussed. It is concluded that
anorexia's clear-cut symptoms and the availability of reliable outcome measures make it useful for evaluating treatments. (PsycINFO Database Record
(c) 2008 APA, all rights reserved).
Archives of General
Psychiatry, 44(12) : 1047-1056
- Year: 1987
- Problem: Anorexia Nervosa, Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy, Supportive
therapy
Halmi, K. A., Eckert, E., LaDu, T. J., Cohen, J.
Patients with anorexia nervosa
have concurrent problems of emaciation and depression. Therefore, treatment with medications affecting both weight gain and depression seemed
reasonable. Seventy-two anorectic patients were randomly assigned in a double-blind study to receive cyproheptadine hydrochloride, a weight-inducing
drug, amitriptyline hydrochloride, a tricyclic antidepressant, or placebo. Overall, cyproheptadine had a marginal effect on decreasing the number of
days necessary to achieve a normal weight. There was a differential drug effect present in the bulimic subgroups of the anorectic patients:
cyproheptadine significantly increased treatment efficiency for the nonbulimic patients and significantly impaired treatment efficiency for the
bulimic patients when compared with the amitriptyline- and placebo-treated groups. The differential cyproheptadine effect on the anorectic bulimic
subgroups is the first pharmacologic evidence of the validity of these subgroups. Cyproheptadine had an anti-depressant effect demonstrated by a
significant decrease in the Hamilton depression ratings.
Archives of General Psychiatry, 43(2) : 177-81
- Year: 1986
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Tricyclic antidepressants, Appetite
moderators
Biederman, J., Herzog, D. B., Rivinus, T. M., Harper, G. P., Ferber, R. A., Rosenbaum, J. F., Harmatz, J. S., Tondorf, R., Orsulak, P. J., Schildkraut, J. J.
The tricyclic antidepressant drug amitriptyline was evaluated as a short-term treatment of anorexia nervosa patients. In a 5-
week double-blind, placebo-controlled study 11 patients were given amitriptyline and 14 received placebo. In addition, 18 patients who refused to
participate in the drug trial and received only psychosocial treatment were used as an additional comparison group. Overall, patients in the three
groups showed little improvement. No statistically significant differences favoring amitriptyline were found in any of the outcome variables. Plasma
levels varied widely among patients receiving similar doses. No association was found between plasma levels and improvement in either psychiatric
symptomatology or weight. Amitriptyline patients did not manifest any tendency for a reduction of depressive symptomatology. In addition,
amitriptyline treatment was associated with substantial discomfort and adverse affects.
Journal of Clinical Psychopharmacology, 5(1) : 10-
6
- Year: 1985
- Problem: Anorexia Nervosa
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Tricyclic antidepressants
Gross, H. A., Ebert, M. H., Faden, V. B.
In this 4-week, double-blind, parallel group study, eight young women with primary anorexia nervosa were evaluated on lithium carbonate,
and eight patients were treated with placebo and served as a control. All patients participated in a behavior modification treatment program. The
lithium-treated and placebo groups were comparable on nearly all findings measured at baseline (t tests), witn no significant differences observed
except for calories per day, percent fat composition of the daily calories, 'interpersonal sensitivity' on the Hopkins Symptom Checklist-90 (HSCL-
90), 'self-care' on the Goldberg Anorectic Attitude Questionnaire, (GAAQ) and 'manipulation of others' on the physician-rated Psychiatric Rating
Scale (PRS). The data were analyzed using repeated measures analysis of covariance (ANCOVA) with the baseline measure as the covariate. Group
differences appeared in the areas of 'denial or minimization of illness' on the GAAQ, 'selective appetite' on the PRS, and weight. Although the
repeated measures ANCOVA for weight revealed a significant group-by-time interaction, indicating nonparallelism and invalidating the test for group
differences, ANCOVAs performed for each individual time point showed greater weight gain in the lithium group at week 3 and 4.
Journal of Clinical Psychopharmacology., 1(6) : 376-381
- Year: 1981
- Problem: Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Lithium