Cognitive-Behavioural Therapy for Bulimia nervosa and Binge Eating Disorder

Background: The aim of this study was to assess the relationship between body image and suicidal tendencies in anorexia nervosa (AN). Methods: Three groups of hospitalized female adolescents – nonsuicidal AN, suicidal psychiatric and nonsuicidal psychiatric patients, as well as a community control group with no psychiatric disturbances were compared with regard to suicidal tendencies (in the form of attitudes to life and death), body image and experience, depression and anxiety. Results: The AN and suicidal patients showed less attraction to but more repulsion by life, and more attraction to and less repulsion by death compared with the other two groups. The AN and suicidal patients were also different from either one or both control groups in showing more negative attitudes and feelings towards their bodies, lower sensitivity to body clues, less body control, and elevated depression and anxiety. These between-group differences in suicidal tendencies were retained after controlling for age, body mass index, the different body image dimensions, anxiety and depression. Conclusions: Our findings suggest that female AN inpatients with no evidence of overt suicidal behavior demonstrate elevated suicidal tendencies that are similar to those of suicidal psychiatric inpatients. These self-destructive tendencies are highly associated with a pervasive sense of disturbance of body image and experience.

Section: Discussionmentioning

confidence: 99%

Suicidal Tendencies and Body Image and Experience in Anorexia nervosa and Suicidal Female Adolescent Inpatients

Stein

Orbach

Shani-Sela

et al. 2002

“…Psychotherapeutic interventions can seldom be avoided in patients with AN; however, in those with bulimia nervosa, cognitive behavioral therapy (CBT) has showed good efficacy [3], but data regarding AN are still not available. Psychotherapeutic interventions in AN can be either supportive or centered more on insight [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Dropout from Brief Psychotherapy in Anorexia nervosa

Fassino

Abbate-Daga

Pierò

et al. 2002

Background: Dropout from psychotherapy is an important issue that has received little systematic attention. This study investigated the phenomenon of dropout from brief psychotherapy for anorexia nervosa (AN). Methods: 99 outpatients suffering from AN of the restrictor type (n = 53) or binge/purging type (n = 46) were evaluated. Their clinical and personal characteristics were recorded, and body mass index was calculated for participants. They were administered the Eating Disorder Inventory-II (EDI-II), the State-Trait Anger Expression Inventory (STAXI) and the Temperament and Character Inventory (TCI). Results: Significant differences in some baseline psychopathologic (EDI-II, STAXI) and personality (TCI) variables emerged from the comparison between dropouts and completers. Patients who dropped out of the treatment showed higher levels of anger temperament, anger expression-in and expression-out and lower scores for the dimensions of character (low self-directedness and low cooperativeness). No differences were found between the two groups regarding sociodemographic and clinical variables. Conclusions: Dropout from brief psychotherapy seems to be related to either psychopathologic or personality aspects, such as the tendency to repress anger, which is encountered also in psychosomatic disorders, and the presence of more compromised dimensions of character, typical of subjects with personality disorders. This study of dropout from brief psychotherapy in AN provided interesting results that will need further confirmation. Possible implications for treatment are addressed.

“…The two main therapeutic targets in patients with BED are weight loss and the elimination of binges. Treatments originally developed for bulimia nervosa, such as cognitive-behavioural therapy (CBT), have been employed in patients with BED [6], as well as pharmacological treatments previously reported to induce weight loss and antidepressant medications. Individual and group CBT [7, 8, 9, 10, 11, 12, 13]have been reported to decrease the frequency of binges, without inducing a significant weight loss.…”

Section: Introductionmentioning

confidence: 99%

Fluoxetine and Fluvoxamine Combined with Individual Cognitive-Behaviour Therapy in Binge Eating Disorder: A One-Year Follow-Up Study

Ricca¹,

Mannucci

Mezzani

et al. 2001

Self Cite

106

Background: The treatment of binge eating disorder (BED) is still the object of debate. In the present study, the effectiveness of antidepressant drugs (fluoxetine – FLX – 60 mg/day, fluvoxamine – FLV –300 mg/day), cognitive-behavioural therapy (CBT) and combined treatments (CBT + FLX, CBT + FLV) has been evaluated in a randomized, clinical trial. Results at the end of the active treatment (in the 24th week) and 1-year follow-up outcomes have been evaluated. Methods: One hundred eight (44 M, 64 F) BED patients were randomly assigned to either CBT, FLX (60 mg/day), FLV (300 mg/day), CBT + FLX or CBT + FLV, for 24 weeks. At the beginning (T0), at the end (T1) of treatment and after 1 year (T2), body mass index (BMI) and eating attitude and behaviours (by EDE 12.0D) were assessed. Results: At T1, BMI and EDE scores were significantly reduced in CBT, CBT + FLX and CBT + FLV, but not in the FLX and FLV treatment groups. In the CBT + FLV group, a greater (p < 0.05) reduction of EDE total scores was observed, when compared to CBT + FLX or CBT treatment groups. At T2, BMI was significantly higher than at T1, but still significantly lower than at T0 in the CBT, CBT + FLX and CBT + FLV groups, while EDE scores remained unchanged from T1 in all treatment groups. Conclusions: CBT was more effective than FLX or FLV in the treatment of BED. The addition of FLX to CBT does not seem to provide any clear advantage, while the addition of FLV could enhance the effects of CBT on eating behaviours. Modifications of eating behaviours are maintained at the 1-year follow-up, although the lost weight was partly regained.