Comparison of cognitive-behavioral and supportive-expressive therapy for bulimia nervosa

Garner, David M.; Rockert, Wendi; Davis, Ron; Garner, Maureen V.; Olmsted, Marion P.; Eagle, Morris N.

doi:10.1176/ajp.150.1.37

Cited by 205 publications

(20 citation statements)

References 29 publications

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“…In 2 further RCTs comparing PDT with CBT, no differences were found in the primary (disorder-specific) outcome measures (bulimic episodes, self-induced vomiting) [88,89]. Again, however, the studies were not sufficiently powered to detect moderate differences (online suppl.…”

Section: Methodsmentioning

confidence: 99%

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

Leichsenring

Leweke

Klein

et al. 2015

Psychother Psychosom

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Background: The Task Force on Promotion and Dissemination of Psychological Procedures proposed rigorous criteria to define empirically supported psychotherapies. According to these criteria, 2 randomized controlled trials (RCTs) showing efficacy are required for a treatment to be designated as ‘efficacious' and 1 RCT for a designation as ‘possibly efficacious'. Applying these criteria modified by Chambless and Hollon, this article presents an update on the evidence for psychodynamic therapy (PDT) in specific mental disorders. Methods: A systematic search was performed using the criteria by Chambless and Hollon for study selection, as follows: (1) RCT of PDT in adults, (2) use of reliable and valid measures for diagnosis and outcome, (3) use of treatment manuals or manual-like guidelines, (4) adult population treated for specific problems and (5) PDT superior to no treatment, placebo or alternative treatment or equivalent to an established treatment. Results: A total of 39 RCTs were included. Following Chambless and Hollon, PDT can presently be designated as efficacious in major depressive disorder (MDD), social anxiety disorder, borderline and heterogeneous personality disorders, somatoform pain disorder, and anorexia nervosa. For MDD, this also applies to the combination with pharmacotherapy. PDT can be considered as possibly efficacious in dysthymia, complicated grief, panic disorder, generalized anxiety disorder, and substance abuse/dependence. Evidence is lacking for obsessive-compulsive, posttraumatic stress, bipolar and schizophrenia spectrum disorder(s). Conclusions: Evidence has emerged that PDT is efficacious or possibly efficacious in a wide range of common mental disorders. Further research is required for those disorders for which sufficient evidence does not yet exist.

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Section: Methodsmentioning

confidence: 99%

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

Leichsenring

Leweke

Klein

et al. 2015

Psychother Psychosom

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“…Restricting their review to recent, comparable controlled studies, Fairburn et al [8]reported a reduction of frequency of binge episodes ranging between 73 and 93%, and a reduction of compensatory behaviours of 77–94%. Other controlled trials also show a complete remission of bulimic symptoms in 51–71% of cases, and of compensatory behaviours in 36–56% [9, 10, 11, 12]. …”

Section: Efficacy Of Cbt In Bnmentioning

confidence: 98%

“…Other results reported in recent controlled trials of CBT in BN include: (1) a significant reduction of restriction over eating [10, 12, 13], with an increase in the amount of food eaten in between the bulimic episodes [14]; (2) an improvement in preoccupations over body weight and shape [10, 12, 13], and (3) a relevant improvement in mood depression, self-esteem, social functioning and associated personality disorders [8, 12, 15]. Results are usually maintained at 6-month, 1-year and 6-year follow-up [13, 16, 17, 18].…”

Section: Efficacy Of Cbt In Bnmentioning

confidence: 99%

“…Controlled studies have shown that CBT is more effective than supportive psychotherapy [9], supportive psychotherapy plus antidepressant medication [28]and supportive-expressive psychotherapy [12]. Exposure plus response prevention method for preventing self-induced vomiting is less effective than CBT in long-term follow-up [20], does not increase the efficacy of CBT [29], and may even have detrimental effects when combined with CBT [21].…”

Section: Efficacy Of Cbt In Bnmentioning

confidence: 99%

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Cognitive-Behavioural Therapy for Bulimia nervosa and Binge Eating Disorder

Ricca

Mannucci²,

Zucchi³

et al. 2000

Psychother Psychosom

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Cognitive-behavioural therapy (CBT) programmes for bulimia nervosa (BN) have been considerably refined during the last 2 decades, and such a treatment is now extensively used. The present paper describes the treatment rationale and structure, and reviews the available evidence on its efficacy. Compared to any other psychological or pharmacological treatment for which controlled studies have been published, CBT is reported to be more effective (the majority of studies), or at least as effective. A CBT programme for binge eating disorder (BED) has been created by adapting that of BN, but it has been less extensively evaluated in field trials. Even here, however, no other treatment has proven to be of greater efficacy than CBT. Various methodological limitations reduce the possibility of generalizing these findings. Moreover, CBT was found to be completely satisfactory neither for BN nor for BED, with moderate effectiveness and some limits. However, at the present state of treatment, no other therapeutical procedure seems to be more effective, more specific or more promising. It is speculated therefore that CBT could be presently considered the first-choice remedy for these severely disabling disorders.

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“…CBT also led to significantly greater decreases than supportive-expressive therapy (a nondirective psycho dynamically oriented treatment) in EDI bulimia, EAT scores, food preoccupation, eating concerns, and depression. [133] Exercise therapy was superior to CBT at 18-month follow-up in improving drive for thinness, laxative abuse, and binge eating. [134]…”

Section: Treatment Of Bulimia Nervosamentioning

confidence: 99%

Management of anorexia and bulimia nervosa: An evidence-based review

Chakraborty

Basu

2010

Indian J Psychiatry

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Anorexia nervosa and bulimia nervosa are primarily psychiatric disorders characterized by severe disturbances of eating behavior. Eating disorders are most prevalent in the Western culture where food is in abundance and female attractiveness is equated with thinness. Eating disorders are rare in countries like India. Despite a plethora of management options available to the mental health professionals, no major breakthrough has been achieved in recent years. Nutritional rehabilitation along with some form of re educative psychotherapy remains the mainstay of management of anorexia nervosa. In bulimia nervosa, both fluoxetine and cognitive behavior therapy have been found to be effective. Although the above-mentioned management options have been in use for decades, the active ingredient is still to be ascertained.

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Comparison of cognitive-behavioral and supportive-expressive therapy for bulimia nervosa

Cited by 205 publications

References 29 publications

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

Cognitive-Behavioural Therapy for Bulimia nervosa and Binge Eating Disorder

Management of anorexia and bulimia nervosa: An evidence-based review

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