Long-term course in 14 bulimic patients treated with psychotherapy

Fourteen patients with bulimia were treated with group psychotherapy and with strategic use of antidepressants and individual psychotherapy as needed. The 12 who achieved sustained remission required an average of 21 months of treatment. Patients with both an axis I and an axis II diagnosis did less well and required longer treatment than those who met criteria for bulimia only. Bulimic symptoms varied substantially with time, so that a definition of remission requiring that a patient be symptom-free for 6 months was more accurate than acute outcome data. Patients with comorbid affective disorders, personality disorders, and bulimia had the poorest prognosis.