Individuals with eating disorders have significantly elevated mortality rates, with the highest rates occurring in those with AN. The mortality rates for BN and EDNOS are similar. The study found age at assessment to be a significant predictor of mortality for patients with AN. Further research is needed to identify predictors of mortality in patients with BN and EDNOS.
Objective-The aim of this study was to compare two cognitive-behavioral treatments for outpatients with eating disorders, one focusing solely on eating disorder features and the other a more complex treatment that also addresses mood intolerance, clinical perfectionism, low selfesteem, or interpersonal difficulties.Method-A total of 154 patients who had a DSM-IV eating disorder but were not markedly underweight (body mass index over 17.5), were enrolled in a two-site randomized controlled trial involving 20 weeks of treatment and a 60-week closed period of follow-up. The control condition was an 8-week waiting list period preceding treatment. Outcomes were measured by independent assessors who were blind to treatment condition.Results-Patients in the waiting list control condition exhibited little change in symptom severity, whereas those in the two treatment conditions exhibited substantial and equivalent change, which was well maintained during follow-up. At the 60-week follow-up assessment, 51.3% of the sample had a level of eating disorder features less than one standard deviation above the community mean. Treatment outcome did not depend on eating disorder diagnosis. Patients with marked mood intolerance, clinical perfectionism, low self-esteem, or interpersonal difficulties appeared to respond better to the more complex treatment, with the reverse pattern evident among the remaining patients.Conclusions-These two transdiagnostic treatments appear to be suitable for the majority of outpatients with an eating disorder. The simpler treatment may best be viewed as the default version, with the more complex treatment reserved for patients with marked additional psychopathology of the type targeted by the treatment.DSM-IV recognizes two specific eating disorders, anorexia nervosa and bulimia nervosa, together with a residual diagnostic category termed "eating disorder not otherwise specified" (1). In outpatient settings, the most common eating disorder diagnosis is eating disorder not otherwise specified, followed by bulimia nervosa and then anorexia nervosa (2-5). Despite its prevalence, there have been no studies of the treatment of eating disorder not otherwise specified. Some treatment studies have included subthreshold cases of anorexia nervosa or bulimia nervosa (6, 7), and there has been interest in binge eating disorder (8), a subtype of eating disorder not otherwise specified, but such cases constitute less than half those with eating disorder not otherwise specified (5 Europe PMC Funders Author ManuscriptsEurope PMC Funders Author Manuscripts which the features of anorexia nervosa and bulimia nervosa are combined in various ways (5). The treatment of these patients has not been studied.Given that the clinical features of bulimia nervosa and eating disorder not otherwise specified are very similar, it has been postulated that treatments that have beneficial effects on bulimia nervosa should also benefit patients with eating disorder not otherwise specified (9). Were this to be the case, such tr...
BackgroundThis study aimed to determine the psychometric properties of the Compulsive Exercise Test (CET) among an adult sample of patients with eating disorders.MethodThree hundred and fifty six patients and 360 non-clinical control women completed the CET and the Eating Disorders Examination questionnaire (EDE-Q).ResultsA confirmatory factor analysis revealed that the clinical data showed a moderate fit to the previously published five factor model derived from a community sample (Taranis L, Touyz S, Meyer C, Eur Eat Disord Rev 19:256-268, 2011). The clinical group scored significantly higher than the non-clinical group on four of the five CET subscales, and logistic regression analysis revealed that the CET could successfully discriminate between the two groups. A Receiver Operating Curve analysis revealed that a cut-off score of 15 on the CET resulted in acceptable values of both sensitivity and specificity.ConclusionsThe CET appears to have a factor structure that is acceptable for use with an adult sample of patients with eating disorders. It can identify compulsive exercise among patients with eating disorders and a cut-off score of 15 is acceptable as indicating an appropriate cut-off point.
CBT-AN and LEAP added to CBT-AN resulted in improved attitudes and beliefs toward exercise and general improvements in BMI and ED psychopathology in people with AN.
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