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A randomised controlled trial of three psychological treatments for anorexia nervosa

Published online by Cambridge University Press:  29 May 2017

S. Byrne ,
T. Wade ,
P. Hay ,
S. Touyz ,
C. G. Fairburn ,
J. Treasure ,
U. Schmidt ,
V. McIntosh ,
K. Allen  and
A. Fursland
...Show all authors
S. Byrne*
Affiliation:
School of Psychology, The University of Western Australia, Perth, Australia Centre for Clinical Interventions, Perth, Australia
T. Wade
Affiliation:
School of Psychology, Flinders University, Adelaide, Australia
P. Hay
Affiliation:
School of Medicine & Centre for Health Research, Western Sydney University, Sydney, Australia
S. Touyz
Affiliation:
School of Psychology, Sydney University, Sydney, Australia
C. G. Fairburn
Affiliation:
Department of Psychiatry, Oxford University, Oxford, UK
J. Treasure
Affiliation:
Department of Psychological Medicine, Kings College London, London, UK
U. Schmidt
Affiliation:
Department of Psychological Medicine, Kings College London, London, UK
V. McIntosh
Affiliation:
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
K. Allen
Affiliation:
School of Psychology, The University of Western Australia, Perth, Australia Department of Psychological Medicine, Kings College London, London, UK Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK
A. Fursland
Affiliation:
Centre for Clinical Interventions, Perth, Australia School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia
R. D. Crosby
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA Department of Biostatistics, Neuropsychiatric Research Institute, Fargo, ND, USA
*
*Address for correspondence: Susan Byrne, University of Western Australia, School of Psychology, 35 Stirling Highway, CRAWLEY, Perth, Western Australia 6009, Australia. (Email: [email protected])
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Abstract

Background

There is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy.

Method

A multi-centre randomised controlled trial was conducted with outcomes assessed at pre-, mid- and post-treatment, and 6- and 12-month follow-up by researchers blind to treatment allocation. All analyses were intention-to-treat. One hundred and twenty individuals meeting diagnostic criteria for AN were recruited from outpatient treatment settings in three Australian cities and offered 25–40 sessions over a 10-month period. Primary outcomes were body mass index (BMI) and eating disorder psychopathology. Secondary outcomes included depression, anxiety, stress and psychosocial impairment.

Results

Treatment was completed by 60% of participants and 52.5% of the total sample completed 12-month follow-up. Completion rates did not differ between treatments. There were no significant differences between treatments on continuous outcomes; all resulted in clinically significant improvements in BMI, eating disorder psychopathology, general psychopathology and psychosocial impairment that were maintained over follow-up. There were no significant differences between treatments with regard to the achievement of a healthy weight (mean = 50%) or remission (mean = 28.3%) at 12-month follow-up.

Conclusion

The findings add to the evidence base for these three psychological treatments for adults with AN, but the results underscore the need for continued efforts to improve outpatient treatments for this disorder.

Trial Registration

Australian New Zealand Clinical Trials Registry (ACTRN 12611000725965) http://www.anzctr.org.au/

Keywords

Adultsanorexia nervosapsychological treatmentsrandomised controlled trial.
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 16 , December 2017 , pp. 2823 - 2833
Copyright
Copyright © Cambridge University Press 2017 

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