1. Treating severe and enduring anorexia nervosa: a randomized controlled trial.
- Author
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Touyz, S., Le Grange, D., Lacey, H., Hay, P., Smith, R., Maguire, S., Bamford, B., Pike, K. M., and Crosby, R. D.
- Subjects
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ANOREXIA nervosa treatment , *PSYCHOTHERAPY methodology , *COGNITIVE therapy , *ADAPTABILITY (Personality) , *AFFECTIVE disorders , *ANALYSIS of variance , *HEALTH behavior , *OUTPATIENT services in hospitals , *LONGITUDINAL method , *CLASSIFICATION of mental disorders , *MOTIVATION (Psychology) , *HEALTH outcome assessment , *PSYCHOLOGICAL tests , *QUALITY of life , *QUESTIONNAIRES , *RESEARCH funding , *SELF-evaluation , *STATISTICAL hypothesis testing , *LOGISTIC regression analysis , *EFFECT sizes (Statistics) , *BODY mass index , *RANDOMIZED controlled trials , *SOCIAL services case management , *TREATMENT effectiveness , *REPEATED measures design , *DATA analysis software , *DESCRIPTIVE statistics - Abstract
BackgroundThere 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.MethodSixty-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.ResultsThirty-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.ConclusionsPatients 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. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
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