Disorders - Bulimia Nervosa
Mitchell, James E., Pyle, Richard L., Eckert, Elke D., Hatsukami, Dorothy, et al.,
Bulimic women were assigned to 1 of 4 treatment conditions: (1) imipramine hydrochloride, (2) placebo, (3) imipramine with outpatient
group psychotherapy, and (4) placebo with outpatient group therapy. Results suggest that structured, intensive group therapy programs combining
cognitive behavioral, behavioral, and nutritional counseling techniques provide a therapeutic strategy that can be effective with and acceptable to
most bulimia patients. This intervention appears to be more effective than antidepressant treatment alone in suppressing bulimic symptoms. However,
bulimic Ss with significant depression at baseline evaluation may benefit from the addition of an antidepressant to their treatment regimen.
(PsycINFO Database Record (c) 2008 APA, all rights reserved).
Archives of General Psychiatry, 47(2) : 149-
157
- Year: 1990
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Tricyclic antidepressants, Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Other Psychological Interventions, Dietary advice, dietary change
Mitchell, James E., Fletcher, Linda, Pyle, Richard, Eckert, Elke, et al.,
Examined the effects of different interventions on the numbers
of meals plus snacks eaten each day for 80 females (aged 18-40 yrs) who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-III)
criteria for bulimia. Ss were randomly assigned to 1 of 4 treatment cells: treatment with the antidepressant drug imipramine HC1 with outpatient
group therapy (GT), imipramine without GT, placebo plus GT, or placebo alone. The cognitive behavioral group psychotherapy component appeared to
increase the number of meals plus snacks Ss reported eating each day during the acute treatment phase. Antidepressant medication had less impact on
the number of meals and snacks eaten. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
International Journal of Eating Disorders, 8(2) : 167-172
- Year: 1989
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Tricyclic antidepressants, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Pope, HG., Keck,
PE., McElroy, SL., Hudson, JI.
42 women (aged 19-38 yrs) who met the Diagnostic and Statistical Manual of Mental Disorders-
III--Revised (DSM-III--R) criteria for bulimia nervosa completed a placebo-controlled, double-blind study with the antidepressant trazodone (TZ).
Findings indicate that TZ was significantly superior to placebo, both in reducing the frequency of binge eating and vomiting and in several of the
Ss' subjective ratings of improvement. Excluding 3 Ss who were probably not compliant with their medication, 7 of 17 Ss taking TZ experienced at
least a 50% reduction in binge eating episodes and rated themselves as \"very much\" or \"moderately\" improved. However, only 2 of these Ss
experienced a complete remission of binge eating. TZ produced few bothersome side effects. (PsycINFO Database Record (c) 2008 APA, all rights
reserved).
Journal of Clinical Psychopharmacology, 9(4) : 254-
259
- Year: 1989
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other antidepressants
Hudson, J. I., Pope Jr, H. G., Keck Jr, P. E., McElroy, S. L.
In a
6-week, placebo-controlled, double-blind study of trazodone in 42 women with bulimia nervosa, trazodone was well tolerated and proved significantly
superior to placebo in reducing the frequency of episodes of binge eating and vomiting. Nine- to 19-month follow-up of 36 study subjects revealed
that 26 (72%) continued improved, with 18 (36%) in remission. Most remained on trazodone or another antidepressant at follow-up.
Clinical
Neuropharmacology., 12(SUPPL. 1) : S38-S46
- Year: 1989
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Tricyclic antidepressants
Mitchell, JE., Christenson,
G., Jennings, J., Huber, M., et-al.,
16 normal-weight bulimic women
(mean age 23.7 yrs) were treated with 50 mg naltrexone (NA) and placebo in a crossover design. Ss completed the Hamilton Rating Scale for Depression
and a self-monitoring instrument at weekly clinic visits. Findings show that NA was not associated with a clinically significant reduction in
bingeing or vomiting. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Journal of Clinical Psychopharmacology, 9(2) : 94-97
- Year: 1989
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions
Berry,
Diana M., Abramowitz, Stephen I.
27 female college students were randomly assigned to 1 of 4 conditions: (1) educative/support
group plus experimental stimulus, (2) educative/support group plus neutral stimulus, (3) attention/placebo plus experimental stimulus, and (4)
attention/placebo plus neutral stimulus. The educative/support group had significant ameliorative effects on bingeing and symptoms of emotional
distress, regardless of whether or not it was paired with subliminal psychodynamic activation. Decreases in several psychological traits associated
with eating disorders were found among all Ss irrespective of treatment conditions. Subliminal psychodynamic activation appeared to exert an
independent treatment effect on restrained eating and certain symptoms of emotional distress. Clinical and theoretical implications are discussed and
related to current proposed etiologies of bulimia. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
International Journal of Eating Disorders, 8(1) : 75-85
- Year: 1989
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Psychodynamic/Psychoanalysis, Psychoeducation
Blouin, AG., Blouin, JH., Perez,
EL., Bushnik, T, et-al.,
Administered desipramine and
fenfluramine to bulimic adults in a 15-wk study of double-blind, placebo-controlled, crossover design. The 22 Ss met Diagnostic and Statistical
Manual of Mental Disorders (DSM-III) criteria for bulimia and were of normal weight. An eating disorder inventory, the Profile of Mood States,
bulimia symptom checklists, and the SCL-90 were administered at Weeks 0, 2, 4, 6, 9, 11, 13, and 15. Results indicate that both drugs had beneficial
effects on bingeing and vomiting frequency, although a greater proportion of Ss were identified who responded to fenfluramine. Both drugs were also
effective in reducing the psychological symptoms of bulimia, such as the urge to binge and feelings of depression. (PsycINFO Database Record (c) 2008
APA, all rights reserved).
Journal of Clinical Psychopharmacology, 8(4) : 261-
269
- Year: 1988
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Tricyclic antidepressants, Appetite
moderators
Russell, G. F. M., Checkley, S. A., Feldman, J., Eisler, I.
A double-blind, placebo-controlled trial of d-
fenfluramine in bulimia nervosa was undertaken in order to assess its efficacy in controlling bulimic behavior and relieving more general symptoms. A
high proportion of the patients evaluated were reluctant to enter the drug trial in spite of the offer of additional supportive psychotherapy and
counselling on dietary control. Moreover, 17 out of the 42 enrolled patients withdrew halfway through the 12 week trial. Were it not for this high
rate of defaulting, there might be clearer support for the efficacy of d-fenfluramine in reducing the frequency of overeating and self-induced
vomiting in these bulimic patients. An unexpected finding was that among the noncompleters, those on d-fenfluramine had experienced relief of their
bulimic symptoms. The persistence of depressive symptoms and features of the eating disorder probably contributed to the noncompleters leaving the
trial. Reassuring findings were the absence of weight loss and serious unwanted effects from d-fenfluramine. By itself, d-fenfluramine did not
benefit some of the patients with severe bulimia nervosa, but it may yet prove a useful adjunct to psychological treatments.
Clinical
Neuropharmacology., 11(SUPPL. 1) : S146-S159
- Year: 1988
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Appetite
moderators
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
Fairburn, Christopher G., Kirk, Joan, O'Connor,
Marianne, Cooper, Peter J.
Compared 2 standardized psychological treatments for bulimia nervosa--a cognitive behavioral approach and a short-term focal
psychotherapy. 24 female patients (mean age 22.9 yrs) with bulimia nervosa were randomly allocated to the 2 treatments. Assessments took place at the
beginning and end of treatment and at 4-, 8-, and 12-mo follow-up. Ss in both groups made substantial improvements that were well maintained over the
12-mo treatment-free follow-up period. The cognitive behavioral approach was superior to short-term focal psychotherapy in terms of its effect on the
Ss' overall clinical state, their general psychopathology and social adjustment, and their assessment of their outcome. (54 ref) (PsycINFO Database
Record (c) 2008 APA, all rights reserved).
Behaviour Research & Therapy, 24(6) : 629-643
- Year: 1986
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Hughes,
Patrick L., Wells, Lloyd A., Cunningham, Carol J., Ilstrup, Duane M.
Conducted a double-blind,
placebo-controlled, partial-crossover trial to study the effect of desipramine hydrochloride (target dose 200 mg/day) treatment, using 22 18-40 yr
old bulimic patients without major depressive disorder. Results show that desipramine demonstrated both a significant benefit in comparison with
placebo and a clinically significant benefit in comparison with baseline status. Improvement was equal in Ss both in and out of the blind study
protocol, and it persisted at 1-mo follow-up. (15 ref) (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Archives of General Psychiatry, 43(2) : 182-186
- Year: 1986
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs)
Robinson, P. H., Checkley, S. A., Russell, G. F.
Fifteen patients with bulimia nervosa received fenfluramine (60 mg po) or placebo under double-blind, randomly ordered
conditions. Two hours later food was presented. Significantly less food was eaten after fenfluramine and the quantity eaten was inversely correlated
with serum fenfluramine levels. Significantly fewer patients reported bulimic symptoms during the test after fenfluramine, but no significant effect
was demonstrated after leaving the ward. Fenfluramine caused drowsiness but did not reduce hunger ratings. Similarly, eating failed to reduce hunger
ratings normally in the patients. These findings suggest that in patients with bulimia nervosa, hunger is reported abnormally and eating is
suppressed by fenfluramine. Bulimic symptoms were probably reduced by fenfluramine, which may prove to be a useful treatment for bulimia nervosa.
British Journal of Psychiatry, 146 : 169-
76
- Year: 1985
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Appetite
moderators