Psychological therapies for adults with anorexia nervosa

Chris Dare · Ivan Eisler · Gerald F. M. Russell · Janet L. Treasure · Liz Dodge

378 citations0/0 files storedThe British Journal of Psychiatry

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Eating Disorders and Behaviors Nutrition, Health and Food Behavior Psychological Treatments and Disorders

Abstract

BACKGROUND: Currently, without systematic evidence, psychotherapy for anorexia nervosa in adults draws on psychodynamic, cognitive and systemic theories. AIMS: To assess effectiveness of specific psychotherapies in out-patient management of adult patients with anorexia nervosa. METHOD: Eighty-four patients were randomised to four treatments: three specific psychotherapies - (a) a year of focal psychoanalytic psychotherapy; (b) 7 months of cognitive-analytic therapy (CAT); (c) family therapy for 1 year - and (d) low contact, 'routine' treatment for 1 year (control). RESULTS: At 1 year, there was symptomatic improvement in the whole group of patients. This improvement was modest, several patients being significantly undernourished at follow-up. Psychoanalytic psychotherapy and family therapy were significantly superior to the control treatment; CAT tended to show benefits. CONCLUSIONS: Psychoanalytic and family therapy are of specific value in the out-patient treatment of adult patients with anorexia.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 1987An Evaluation of Family Therapy in Anorexia Nervosa and Bulimia Nervosa 1975Value of family background and clinical features as predictors of long-term outcome in anorexia nervosa: four-year follow-up study of 41 patients 2000Family Therapy for Adolescent Anorexia Nervosa: The Results of a Controlled Comparison of Two Family Interventions 1995A Prospective Study of Outcome in Bulimia Nervosa and the Long-term Effects of Three Psychological Treatments 1997Family and Individual Therapy in Anorexia Nervosa 1997The Science and Practice of Cognitive Behaviour Therapy

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2012Update on the treatment of anorexia nervosa: review of clinical trials, practice guidelines and emerging interventions 2014Short-term psychodynamic psychotherapies for common mental disorders 2005The empirical and theoretical base of family therapy and multiple family day therapy for adolescent anorexia nervosa 2011Long-term psychodynamic psychotherapy in complex mental disorders: update of a meta-analysis 2013Treating severe and enduring anorexia nervosa: a randomized controlled trial

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