Disorders - Bulimia Nervosa
Field, Tiffany, Schanberg, Saul, Kuhn, Cynthia, Field, Tory, Fierro, Karen, Henteleff, Tanja, Mueller, Cynthia, Yando, Regina, Shaw, Seana, Burman, Iris
24 female adolescent bulimic inpatients were randomly assigned to a massage therapy or a standard treatment group. Results indicate that the massaged patients showed immediate reductions (both self-report and behavior observation) in anxiety and depression. In addition, by the last day of the therapy, they had lower depression scores, lower cortisol (stress) levels, and higher dopamine levels, and showed improvement on several other psychological and behavioral measures. Results suggest that massage therapy is effective as an adjunct treatment for bulimia. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Adolescence, 33(131) : 555-563
- Year: 1998
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Massage
Goldbloom, David S., Olmsted, Marion, Davis, Ron, Clewes, Janet, Heinmaa, Margus, Rockert, Wendi, Shaw, Brian
Compared and combined fluoxetine and individual cognitive behavioral therapy in the treatment of bulimia nervosa. Participants were 76 women (18-45 yrs old) who sought treatment at the Eating Disorders Program of the Toronto Hospital and who met Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) criteria for bulimia nervosa. Ss were randomly assigned to receive fluoxetine alone, cognitive behavior therapy alone, or the two in combination and were treated over 16 wks. Short-term outcome revealed that all 3 treatment conditions were associated with clinical improvement across a wide range of parameters. The combination of pharmacotherapy and psychotherapy was superior to pharmacotherapy alone on specific parameters and there was no statistically significant advantage to the combination over psychotherapy alone. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Behaviour Research & Therapy, 35(9) : 803-811
- Year: 1997
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Beumont, Pierre J., Russell, Janice D., Touyz, Stephen W., Buckley, Cathy, Lowinger, Kitty, Talbot, Peter, Johnson, Gordon F.
Examined whether nutritional counselling is associated with an improvement in bulimic symptomatology, whether this improvement is maintained during post-treatment follow-up, and whether the addition of fluoxetine confers additional benefit. 67 patients referred to specialist eating disorder services who fulfilled strict diagnostic criteria were treated with intensive nutritional counselling and randomly assigned to either fluoxetine or placebo. After a 1-wk wash-out, active treatment was given over 8 wks, followed by post-treatment interviews at 12 and 20 wks. Both groups of patients improved significantly during treatment. In some respects, the fluoxetine group did slightly better as demonstrated by the items "restraint", "weight concern" and "shape concern" on the Eating Disorder Examination (EDE). Fluoxetine patients decreased their energy intake and lost a modest amount of weight. They went on to regain weight during the follow-up period, returning to levels higher than they were initially. These patients also appeared more likely to have a recurrence of symptoms, as shown by the fall in percentage of binge-free patients and by changes in the EDE. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Australian & New Zealand Journal of Psychiatry, 31(4) : 514-524
- Year: 1997
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Complementary & Alternative Interventions (CAM)
, Dietary advice, dietary change
Andrewes, David G., O'Connor, Peter, Mulder, Claudia, McLennan, Jim, et al.,
Assessed a new computer-based method of health education for patients with bulimia and anorexia nervosa. 54 patients with eating disorders were allocated randomly to 1 of 2 groups to receive either a computer-presented health education package (DIET) or a placebo computer-based program. Both groups were assessed before and after intervention on a questionnaire measuring knowledge of eating disorders and a questionnaire measuring attitudes to eating-disordered behavior. The DIET group members were significantly improved when compared to the placebo group in terms of both their knowledge and attitudes towards their disorder. The patients rated the DIET program as being both easy to use and helpful. Thus, the DIET program has been found to be a resource-efficient means of health education for patients with eating disorders. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Australian & New Zealand Journal of Psychiatry, 30(4) : 492-497
- Year: 1996
- Problem: Anorexia Nervosa, Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Technology, interventions delivered using technology (e.g. online, SMS)
Fichter, MM., Kruger, R., Rief, W., Holland, R., Dohne, J.
Tested the efficacy of fluvoxamine (FLU) in maintaining improvement of 72 patients with bulimia nervosa treated successfully with inpatient psychotherapy. FLU and placebo, respectively, were given over a period of about 15 wks. The variables assessed concerned bulimic behavior and other aspects of eating disorders, global status, depression, anxieties, obsessive-compulsive behavior, and other aspects of psychopathology. Because the dropout rate was high (33%) and because it was higher in the FLU group (19 out of 37 Ss), analyses were performed on the intent-to-treat sample (all 72 Ss). In both the intent-to-treat and the completer analyses, the following measures showed FLU to have a significant effect in reducing the return of bulimic behavior: (1) self-ratings: Eating Disorder Inventory (EDI); (2) expert ratings: a structured interview for anorexia and bulimia nervosa (SIAB). Two further variables (EDI-total score and SIAB-subscale bulimia) showed the superior relapse prevention effects of FLU compared with placebo for the completer sample. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Journal of Clinical Psychopharmacology, 16(1) : 9-18
- Year: 1996
- Problem: Bulimia Nervosa
- Type: Controlled clinical trials
-
Stage: Relapse prevention
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs)
Kaminski, Patricia L., McNamara, Kathleen
Empirically tested the efficacy of K. McNamara"s (see record 1990-10424-001) 8-wk psychoeducational group program that aims at reducing high risk behaviors for bulimia. 29 college women (mean age 18.3 yrs) evidencing low body esteem, repeated dieting efforts, and other dysfunctional eating behaviors or attitudes were randomly assigned to group treatment or control conditions. Results show at post-test and followup, Ss who received intervention reported significantly improved levels of self-esteem and body satisfaction, and reduction in the reliance on potentially dangerous methods of weight management compared to controls. Ss also reported less fears of negative evaluation by others and endorsed fewer stereotypes about thinness and attractiveness. Ss in the treatment condition showed significantly reduced levels of perfectionism at posttest, but this change was not maintained at follow-up. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Journal of Counseling & Development, 74(3) : 288-294
- Year: 1996
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation
Treasure, J., Schmidt, U., Troop, N., Tiller, J., Todd, G., Turnbull, S.
Background. The aim of this study was to evaluate the effectiveness of a stepped care approach to the treatment of bulimia nervosa: a self-care manual followed, if necessary, by a course of attenuated cognitive behavioural treatment (CBT) in comparison with standard CBT. Method. One hundred and ten patients, presenting at a tertiary referral centre with ICD-10 bulimia nervosa or atypical bulimia nervosa, were randomly assigned to one of two treatment conditions; a) a sequential treatment group: 8 weeks with a self- care manual followed by up to eight sessions of CBT (if still symptomatic) or b) 16 sessions of CBT. Results. Bulimic symptoms improved significantly in both groups with no significant differences between the two groups on any of the measures at the end of treatment or at 18 months follow-up. At end of treatment 30% (95% CI: 18-46%) of the sequential group and 30% (95% CI: 17- 47%) of the standard treatment group were free from all bulimic symptoms. Sixteen of those in the sequential group improved significantly with self- care and did not require additional treatment. The median number of sessions taken by the sequential group was three (95% CI: 0-6). At 18 months follow- up 40% (95% CI: 23-59%) of the sequential group and 41% (95% CI: 25-59%) of the CBT group were symptom free. Conclusions. A sequential approach to the treatment of bulimia may be as effective as standard CBT and can considerably reduce the amount of therapist contact required.
British Journal of Psychiatry., 168(JAN) : 94-98
- Year: 1996
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Kaneva, Riitta, Rissanen, Aila, Sarna, Seppo
Compared the efficacy of fluoxetine with placebo in an 8-wk double-blind study of bulimia nervosa female patients. Efficacy was evaluated by semistructured interviews and self-ratings. 22 patients in the fluoxetine group and 24 in the placebo group completed the study. The ratings of Ss on the Hamilton Rating Scale for Depression and on the depression subscale improved significantly more with fluoxetine than with placebo. The efficacy of fluoxetine emerged within the 1st 4 wks. Clinician-rated anxiety and self-rated anxiety were significantly reduced with fluoxetine. Fluoxetine was superior in increasing the feeling of energy. Fluoxetine also reduced eating-related symptoms, and the patients taking fluoxetine lost weight; in contrast, patients taking placebo gained weight. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Nordic Journal of Psychiatry, 49(4) : 237-242
- Year: 1995
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs)
Cooper, P. J., Steere, J.
In an effort to elucidate the role of cognitive factors in the maintenance of bulimia nervosa, the efficacy of two psychological treatments was examined in a randomised control trial: cognitive behaviour therapy in the absence of explicit exposure instructions was compared with exposure and response prevention treatment in the absence of cognitive restructuring procedures. In the short term both treatments were successful at effecting substantial improvement in both the specific and the non-specific psychopathology of the disorder. However, at a one year follow up, whilst improvements were well maintained for those who had received the cognitive-behavioural treatment, virtually all of those who had responded to the purely behavioural treatment had relapsed. This provides some support for the cognitive model of the maintenance of bulimia nervosa. Nevertheless, the two treatment groups could not be distinguished on post-treatment measures of cognitive disturbance and neither was it the case that residual levels of cognitive disturbance, as assessed, predicted relapse. This may suggest that the level at which the necessary cognitive change takes place may not be accessible by conventional assessment procedures.
Behaviour Research & Therapy., 33(8) : 875-885
- Year: 1995
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Exposure therapy, Exposure and response prevention
Griffiths, Rosalyn A., Hadzi-Pavlovic, Dusan, Channon-Little, Lorna
Reports the pre-post findings from a controlled comparative evaluation of treatments for bulimia nervosa. These pre-post results allow comparison of the hypnobehavioural and cognitive behavioural treatments with a waiting list control group and a comparison of the immediate effects of the 2 modalities. 130 Ss were screened to enter the study. 78 Ss (mean age 25.91 yrs) entered the investigation after being randomly allocated to either a waiting list control group, or to hypnobehavioural or cognitive behavioural groups. The treatments were delivered individually and matched in duration (8 wks) and the number of sessions. Pre- to posttreatment outcome indicated significant differences between the control group and the 2 treatments in reductions in bulimic behaviours and related eating pathology. The immediate effects of both treatments were equal. There were no differences at posttreatment between the treatments in abstinence from either bingeing or purging. The treatment effects were also similar to the immediate effects obtained by longer therapeutic approaches. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
European Eating Disorders Review, 2(4) : 202-220
- Year: 1994
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Treasure, J., Schmidt, U., Troop, N., Tiller, J., Todd, G., Keilen, M., Dodge, E.
Objective - To test the short term efficacy of a self directed treatment manual for bulimia nervosa. Design - Randomised controlled trial of the manual against cognitive behavioural therapy and a waiting list. Setting - Tertiary referral centre. Subjects - 81 consecutive referrals presenting with bulimia nervosa or atypical bulimia nervosa. Main outcome measures - Frequency of binge eating, vomiting, and other behaviours to control weight as ell as abstinence from these behaviours. Results - Cognitive behavioural treatment produced a significant reduction in the frequency of binge eating, vomiting, and other behaviours to control weight. The manual significantly reduced frequency of binge eating and weight control behaviours other than vomiting, and there was no change in the group on the waiting list. Full remission was achieved in five (24%) of the group assigned to cognitive behavioural treatment, nine (22%) of the group who used the manual, and two (11%) of the group on the waiting list. Conclusions - A self directed treatment manual may be a useful first intervention in the treatment of bulimia nervosa.
British Medical Journal., 308(6930) : 686-689
- Year: 1994
- Problem: Bulimia Nervosa, Eating disorders not specified
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Self-help
Garner, D. M., Rockert, W., Davis, R., Garner, M. V., Olmsted, M. P., Eagle, M.
Objective: The authors compared the effectiveness of 4 months (18 sessions) of cognitive-behavioral and supportive-expressive therapy for bulimia. Method: Sixty patients obtained from clinical referrals to an eating disorders program who met modified DSM-III-R criteria for bulimia nervosa were randomly assigned to the two conditions. Treatments were delivered in an individual format, on an outpatient basis, by experienced therapists using treatment manuals. The primary outcome measures were self-induced vomiting, binge eating, and attitudes toward body weight and shape, which were assessed by self-report and structured interview. Results: Fifty patients completed treatment, 25 in each condition. Both treatments led to significant improvements in specific eating disorder symptoms and in psychosocial disturbances. Supportive-expressive therapy was just as effective as cognitive-behavioral therapy in reducing binge eating. Where treatment differences were found, they favored cognitive-behavioral therapy. Cognitive- behavioral therapy was marginally superior in reducing the frequency of self- induced vomiting; 36% of the patients who received cognitive-behavioral therapy and 12% of those who received supportive-expressive therapy abstained from vomiting in the last month of treatment. Cognitive-behavioral therapy was significantly more effective in ameliorating disturbed attitudes toward eating and weight, depression, poor self-esteem, general psychological distress, and certain personality traits. Conclusions: These results moderately favor cognitive-behavioral therapy over supportive-expressive therapy for bulimia nervosa, but follow-up is required to determine the durability of outcome with both modalities. The findings must be interpreted with caution since the selected clinical sample in this study may not represent the bulimia nervosa population.
American Journal of Psychiatry., 150(1) : 37-46
- Year: 1993
- Problem: Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Supportive therapy