Abstract:
BACKGROUND:There are no evidence-based treatments for severe and enduring anorexia nervosa (SE-AN). This study evaluated the relative efficacy of cognitive behavioral therapy (CBT-AN) and specialist supportive clinical management (SSCM) for adults with SE-AN. METHOD:Sixty-three participants with a diagnosis of AN, who had at least a 7-year illness history, were treated in a multi-site randomized controlled trial (RCT). During 30 out-patient visits spread over 8 months, they received either CBT-AN or SSCM, both modified for SE-AN. Participants were assessed at baseline, end of treatment (EOT), and at 6- and 12-month post-treatment follow-ups. The main outcome measures were quality of life, mood disorder symptoms and social adjustment. Weight, eating disorder (ED) psychopathology, motivation for change and health-care burden were secondary outcomes. RESULTS:Thirty-one participants were randomized to CBT-AN and 32 to SSCM with a retention rate of 85% achieved at the end of the study. At EOT and follow-up, both groups showed significant improvement. There were no differences between treatment groups at EOT. At the 6-month follow-up, CBT-AN participants had higher scores on the Weissman Social Adjustment Scale (WSAS; p = 0.038) and at 12 months they had lower Eating Disorder Examination (EDE) global scores (p = 0.004) and higher readiness for recovery (p = 0.013) compared to SSCM. CONCLUSIONS:Patients with SE-AN can make meaningful improvements with both therapies. Both treatments were acceptable and high retention rates at follow-up were achieved. Between-group differences at follow-up were consistent with the nature of the treatments given.
journal_name
Psychol Medjournal_title
Psychological medicineauthors
Touyz S,Le Grange D,Lacey H,Hay P,Smith R,Maguire S,Bamford B,Pike KM,Crosby RDdoi
10.1017/S0033291713000949subject
Has Abstractpub_date
2013-12-01 00:00:00pages
2501-11issue
12eissn
0033-2917issn
1469-8978pii
S0033291713000949journal_volume
43pub_type
杂志文章,多中心研究,随机对照试验abstract::One hundred and sixteen working-class housewives, part-time and full-time employees were compared on a range of well-being measures in three different lifestages. A group of factory employees was contrasted with a 'mixed occupation' group for a comparison of type of employment. The general contention that the associat...
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