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The British Journal of Psychiatry (2001) 178: 216-221
© 2001 The Royal College of Psychiatrists

Psychological therapies for adults with anorexia nervosa

Randomised controlled trial of out-patient treatments

CHRIS DARE, FRCPsych and IVAN EISLER, PhD

Department of Psychiatry, Institute of Psychiatry, King's College London

GERALD RUSSELL, FRCPsych, Emeritus Professor

Institute of Psychiatry, Hayes Grove Priory Hospital, Bromby

JANET TREASURE, FRCPsych

Department of Psychiatry, Institute of Psychiatry, King's College London

LIZ DODGE, CQSW, Family Therapist

Royal Free Eating Disorder Service, London

Correspondence: Dr Christopher Dare, Section of Psychotherapy, Department of Psychiatry, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF

Declaration of interest Research support comes from the Leverhulme Foundation and the Mental Health Research Fund.

Background Currently, without systematic evidence, psychotherapy for anorexia nervosa in adults draws on psychodynamic, cognitive and systemic theories.

Aims To assess effectiveness of specific psychotherapies in out-patient management of adult patients with anorexia nervosa.

Method Eighty-four patients were randomised to four treatments: three specific psychotherapies — (a) a year of focal psychoanalytic psychotherapy; (b) 7 months of cognitive—analytic therapy (CAT); (c) family therapy for 1 year — and (d) low contact, ‘routine’ treatment for 1 year (control).

Results At 1 year, there was symptomatic improvement in the whole group of patients. This improvement was modest, several patients being significantly undernourished at follow-up. Psychoanalytic psychotherapy and family therapy were significantly superior to the control treatment; CAT tended to show benefits.

Conclusions Psychoanalytic and family therapy are of specific value in the out-patient treatment of adult patients with anorexia.




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