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Three psychotherapies for anorexia nervosa: a randomized, controlled trial
Virginia V W McIntosh1, Jennifer Jordan, Frances A Carter
1Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences, P.O. Box 4345, 4 Oxford Terrace, Christchurch, New Zealand. virginia.mcintosh@chmeds.ac.nz
The American Journal of Psychiatry
|April 1, 2005
Summary
Nonspecific supportive clinical management outperformed specialized therapies for anorexia nervosa, challenging existing treatment assumptions. Cognitive behavior therapy showed intermediate results in this eating disorder study.
Area of Science:
- Psychiatry
- Clinical Psychology
- Eating Disorders Research
Background:
- Limited randomized controlled trials exist for anorexia nervosa treatments.
- Cognitive behavior therapy (CBT) and interpersonal psychotherapy (IPT) are effective for bulimia nervosa.
- Theoretical rationale supports CBT and IPT for anorexia nervosa.
Purpose of the Study:
- To compare the efficacy of specialized psychotherapies against a control treatment for anorexia nervosa.
- To investigate the effectiveness of cognitive behavior therapy (CBT) and interpersonal psychotherapy (IPT) in treating anorexia nervosa.
- To evaluate nonspecific supportive clinical management as a treatment for anorexia nervosa.
Main Methods:
- Fifty-six women diagnosed with anorexia nervosa were randomized into three groups.
- Treatments included cognitive behavior therapy (CBT), interpersonal psychotherapy (IPT), and nonspecific supportive clinical management.
- Therapy involved 20 sessions over at least 20 weeks.
Main Results:
- Nonspecific supportive clinical management was superior to IPT for the overall intent-to-treat group.
- CBT yielded intermediate results, not significantly different from either IPT or nonspecific supportive clinical management.
- For completers, nonspecific supportive clinical management surpassed both specialized therapies.
Conclusions:
- The study's main finding contradicts the hypothesis that specialized therapies would be superior.
- Nonspecific supportive clinical management proved more effective than IPT and CBT for anorexia nervosa.
- Results question the assumed effective components of anorexia nervosa treatments.