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Treating Severe and Enduring Anorexia Nervosa: a Randomized Control Trial

Published online by Cambridge University Press:  15 April 2020

S. Touyz ,
D. Le Grange ,
H. Lacey ,
P. Hay ,
R. Smith ,
S. Maguire ,
B. Bamford ,
K. Pike  and
R. Crosby
S. Touyz
Affiliation:
Psychology, The University of Sydney, Sydney, Australia
D. Le Grange
Affiliation:
Psychiatry, University of Chicago, Chicago, USA
H. Lacey
Affiliation:
Psychiatry, University of London, London, United Kingdom
P. Hay
Affiliation:
Psychiatry, University of Western Sydney, Sydney, Australia
R. Smith
Affiliation:
Psychology, University of Sydney, Sydney, Australia
S. Maguire
Affiliation:
CEDD, University of Sydney, Sydney, Australia
B. Bamford
Affiliation:
Psychiatry, University of London, London, United Kingdom
K. Pike
Affiliation:
Psychiatry, Columbia University, New York, USA
R. Crosby
Affiliation:
Psychiatry, Neuropsychiatric Institute, Fargo, USA

Abstract

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There are no evidence-based treatments for severe and enduring anorexia nervosa.

Objective

To evaluate the relative efficacy of Cognitive Behavioral Therapy (CBT) and Specialist Supportive Clinical Management (SSCM) for adults with severe and enduring anorexia nervosa.

Design

Randomised controlled trial.

Participants

Sixty-three participants aged 18 and over (range 20-62) with a DSM-IV diagnosis of anorexia nervosa with at least a seven year illness history.

Interventions

Thirty outpatient visits over 8 months. Participants were assessed at baseline, end of treatment (EOT), and 6-month and 12-month post-treatment follow-up. At EOP and follow-up, both groups improved significantly on the majority of outcome measures. However, there were no differences between treatment groups at EOT. At 6- and 12-month follow-up, analyses indicate greater improvement for those in CBT compared to SSCM. At 6-month follow-up, CBT participants had higher scores on the social adjustment scale (p = .038), and at 12-month they reported lower eating disorder examination global score (p = .004), and higher readiness for recovery (p = .013) compared to SSCM.

Conclusions

Patients with severe and enduring anorexia nervosa can make significant and meaningful improvements with therapy. CBT shows significant advantage over SSCM in terms of social adjustment, core eating pathology, and readiness for change over time.

Type
Article: 0357
Information
European Psychiatry , Volume 30 , Issue S1: Abstracts of the 23rd European Congress of Psychiatry , March 2015 , pp. 1
Copyright
Copyright © European Psychiatric Association 2015
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